The Impact of Taiwan's Implementation of a Nationwide Harm Reduction Program in 2006 on the Use of Various Illicit Drugs: Trend Analysis of First-time Offenders from 2001 to 2017

Overview

Journal Harm Reduct J

Publisher Biomed Central

Specialties Pharmacology
Psychiatry

Date 2021 Nov 20

PMID 34798883

Citations 4

Authors

Wei J Chen

Chi-Ya Chen

Shang-Chi Wu

Kevin Chien-Chang Wu

Susyan Jou

Yu-Chi Tung

Tzu-Pin Lu

Affiliations

Soon will be listed here.

Abstract

Background: After implementing a nationwide harm reduction program in 2006, a dramatic decline in the incidence of human immunodeficiency virus (HIV) infection among people with injection drug use (IDU) was observed in Taiwan. The harm reduction program might have sent out the message discouraging the choice of IDU among illicit drug users in early stage. Based on the yearly first-time offense rates from 2001 to 2017, this study aimed to examine (1) whether the nationwide implementation of the harm reduction program in 2006 led to changes in first-time offenders' use of heroin; (2) whether the intervention had a similar effect on the use of other illicit drugs; and (3) whether the effect of the intervention was limited to the first-time offenders of young age groups.

Methods: Yearly first-time illicit-drug offense rates from 2001 to 2017 in Taiwan were derived from two national databases for drug arrests that were verified using urine tests: the Criminal Record Processing System on Schedule I/II Drugs and the Administrative Penalty System for Schedule III/IV Substances. A hierarchy of mutually exclusive categories of drug uses was defined by the drug with the highest schedule level among those tested positive in an arrest. Segmented regression analyses of interrupted time series were used to test for the impact of the 2006 intervention.

Results: There was a decrease of 22.37 per 100,000 in the rate for heroin but no detectable level changes in that for methamphetamine or ecstasy after the 2006 intervention in Taiwan. There were baseline decreasing trends in the first-time offense rate from 2001 to 2017 for heroin and ecstasy and an increasing trend for methamphetamine, with the slopes not altered by the 2006 intervention. The postintervention decrease in the first-time offense rate for heroin was detectable among offenders less than 40 years old.

Conclusions: Our results indicate a diffusion effect of the 2006 intervention on decreasing heroin use among young offenders and have policy implications for better prevention and treatment for different age groups.

Citing Articles

Using cluster analysis to investigate consumption patterns in cases positive to ketamine: a national 7-year study.

Wei S, Su C, Hu H, Pan C Naunyn Schmiedebergs Arch Pharmacol. 2025; .

PMID: 40085215 DOI: 10.1007/s00210-025-04019-9.

Advancing readiness for change in substance use for people with substance use disorders using the Kawa model based intervention program: A quasi-experimental study.

Hsiao H, Wang T, Lee C, Lu Y, Huang Y, Chien Y Hong Kong J Occup Ther. 2024; 37(2):91-101.

PMID: 39539406 PMC: 11556248. DOI: 10.1177/15691861241268143.

Association between socioeconomic and motherhood characteristics with receiving community-based treatment services among justice-involved young female drug users: a retrospective cohort study in Taiwan.

Chen C, Hsieh T, Rei W, Huang C, Wang S Harm Reduct J. 2024; 21(1):109.

PMID: 38840179 PMC: 11151603. DOI: 10.1186/s12954-024-01010-0.

Assessing the impact of public funding in alleviating participant reduction and improving the retention rate in methadone maintenance treatment clinics in Taiwan: an interrupted time series analysis.

Chung Y, Tung Y, Wang S, Huang C, Chen L, Chen W Implement Sci. 2024; 19(1):18.

PMID: 38389082 PMC: 10885479. DOI: 10.1186/s13012-024-01351-1.

Comparisons of psychological distress and self-stigma among three types of substance use disorders receiving treatment-as-usual approaches: real-world data from a 9-month longitudinal study.

Chang K, Chen H, Huang S, Chen J, Potenza M, Pakpour A Ther Adv Chronic Dis. 2022; 13:20406223221140393.

PMID: 36483780 PMC: 9723802. DOI: 10.1177/20406223221140393.

References

Huang Y, Yang J, Nelson K, Kuo H, Lew-Ting C, Yang C . Changes in HIV incidence among people who inject drugs in Taiwan following introduction of a harm reduction program: a study of two cohorts. PLoS Med. 2014; 11(4):e1001625. PMC: 3979649. DOI: 10.1371/journal.pmed.1001625. View

Chiang S, Chen S, Sun H, Chan H, Chen W . Heroin use among youths incarcerated for illicit drug use: psychosocial environment, substance use history, psychiatric comorbidity, and route of administration. Am J Addict. 2006; 15(3):233-41. DOI: 10.1080/10550490600626473. View

Ting T, Chen C, Tsai Y, Chen Y, Su L, Chen W . Using Social Network as a Recruiting Tool for Research on Substance Use in the Taipei Metropolitan Area: Study Design, Implementation, and Epidemiological Estimates. J Epidemiol. 2015; 25(10):647-55. PMC: 4626394. DOI: 10.2188/jea.JE20140229. View

Walker E, Pratt L, Schoenborn C, Druss B . Excess mortality among people who report lifetime use of illegal drugs in the United States: A 20-year follow-up of a nationally representative survey. Drug Alcohol Depend. 2016; 171:31-38. PMC: 5263065. DOI: 10.1016/j.drugalcdep.2016.11.026. View

Rahman F, Kamarulzaman A . Southeast Asia in focus: stemming the reawakening of prohibitionism. J Int AIDS Soc. 2016; 19(1):21279. PMC: 4923264. DOI: 10.7448/IAS.19.1.21279. View

Yang C, Yang S, Shen M, Kuo H . The changing epidemiology of prevalent diagnosed HIV infections in Taiwan, 1984-2005. Int J Drug Policy. 2008; 19(4):317-23. DOI: 10.1016/j.drugpo.2006.11.016. View

Chen W, Fu T, Ting T, Huang W, Tang G, Hsiao C . Use of ecstasy and other psychoactive substances among school-attending adolescents in Taiwan: national surveys 2004-2006. BMC Public Health. 2009; 9:27. PMC: 2636802. DOI: 10.1186/1471-2458-9-27. View

Mathers B, Degenhardt L, Ali H, Wiessing L, Hickman M, Mattick R . HIV prevention, treatment, and care services for people who inject drugs: a systematic review of global, regional, and national coverage. Lancet. 2010; 375(9719):1014-28. DOI: 10.1016/S0140-6736(10)60232-2. View

Ko N, Koe S, Lee H, Yen C, Ko W, Hsu S . Online sex-seeking, substance use, and risky behaviors in Taiwan: results from the 2010 Asia Internet MSM Sex Survey. Arch Sex Behav. 2012; 41(5):1273-82. DOI: 10.1007/s10508-012-9908-8. View

10.

Li J, Vicknasingam B, Cheung Y, Zhou W, Nurhidayat A, Des Jarlais D . To use or not to use: an update on licit and illicit ketamine use. Subst Abuse Rehabil. 2014; 2:11-20. PMC: 3846302. DOI: 10.2147/SAR.S15458. View

11.

Larance B, Ambekar A, Azim T, Murthy P, Panda S, Degenhardt L . The availability, diversion and injection of pharmaceutical opioids in South Asia. Drug Alcohol Rev. 2011; 30(3):246-54. DOI: 10.1111/j.1465-3362.2011.00304.x. View

12.

Thomson N . Harm reduction history, response, and current trends in Asia. J Food Drug Anal. 2014; 21(4):S113-S116. PMC: 4175908. DOI: 10.1016/j.jfda.2013.09.047. View

13.

Morisky D, Lyu S, Urada L . The Role of Nonformal Education in Combating the HIV Epidemic in the Philippines and Taiwan. Prospects (Paris). 2011; 39(4):335-357. PMC: 3106305. DOI: 10.1007/s11125-010-9133-y. View

14.

Huang S, Wang S, Cowo A, Chen M, Lin Y, Hung C . Molecular Epidemiology of HIV-1 Infection among Men who Have Sex with Men in Taiwan in 2012. PLoS One. 2015; 10(6):e0128266. PMC: 4454672. DOI: 10.1371/journal.pone.0128266. View

15.

Degenhardt L, Copeland J, Dillon P . Recent trends in the use of "club drugs": an Australian review. Subst Use Misuse. 2005; 40(9-10):1241-56. DOI: 10.1081/JA-200066777. View

16.

Lin T, Chen C, Chou P . Effects of combination approach on harm reduction programs: the Taiwan experience. Harm Reduct J. 2016; 13(1):23. PMC: 4932706. DOI: 10.1186/s12954-016-0112-3. View

17.

Chen J . Beyond human rights and public health: citizenship issues in harm reduction. Int J Drug Policy. 2011; 22(3):184-8. DOI: 10.1016/j.drugpo.2010.12.003. View

18.

Wagner A, Soumerai S, Zhang F, Ross-Degnan D . Segmented regression analysis of interrupted time series studies in medication use research. J Clin Pharm Ther. 2002; 27(4):299-309. DOI: 10.1046/j.1365-2710.2002.00430.x. View

19.

Weng T, Chen L, Chen J, Chen P, Hwa H, Fang C . Characteristics of analytically confirmed illicit substance-using patients in the Emergency Department. J Formos Med Assoc. 2020; 119(12):1827-1834. DOI: 10.1016/j.jfma.2020.01.005. View

20.

Chen C, Wu P, Su L, Chou Y, Lin K . Three-year mortality and predictors after release: a longitudinal study of the first-time drug offenders in Taiwan. Addiction. 2010; 105(5):920-7. DOI: 10.1111/j.1360-0443.2009.02894.x. View