Concurrent drug use among methadone maintenance patients in mountainous areas in northern Vietnam

Abstract

ObjectivesWith the rise in methadone maintenance therapy (MMT) for drug users in Vietnam, there has been growing interest in understanding if and how often MMT patients engage in concurrent illicit drug use while on methadone therapy in various settings. This study examined factors associated with concurrent opioid use among patients on MMT in a mountainous area in Vietnam.SettingOne urban and one rural MMT clinics in Tuyen Quang province.ParticipantsSurvey participants consisted of patients who were taking MMT at the selected study sites. A convenience sampling approach was used to recruit the participants.Primary and secondary outcome measuresParticipants were asked a series of questions about their socioeconomic status, current alcohol and tobacco use, health problems (measured by the EuroQol-Five Dimension-Five Level instrument), psychological distress (measured by Kessler score), and factors associated with current and/or previous drug use. Regression models were used to determine factors associated with concurrent drug use among MMT patients.ResultsAmong the 241 male MMT patients included in the study, 13.4% reported concurrent opioid use. On average, the longer patients had been enrolled in MMT, the less likely they were to concurrently use drugs. Conversely, patients with higher levels of psychological distress were more likely to engage in concurrent drug use while on MMT.ConclusionLonger duration of MMT was significantly correlated with reduced illicit drug use among participants. Higher levels of psychological distress were associated with increased use of illicit drugs among MMT patients. Regardless of distance, long-term MMT is still effective and should be expanded in mountainous areas.

Polysubstance Use among Patients Enrolling in Methadone Maintenance Treatment Program in a Vietnam Province with Drug-Driven HIV Epidemic

“…Our finding indicates that tobacco is the most common (81%) substance used among patients participating in the MMT program. This result is in line with previous reports which also found an extremely high level of cigarette use (the prevalence varies between 77% and 88%) in MMT patients [29,31]. Among middle-income countries, Vietnam has a high level of cigarette consumption [27].…”

“…Many factors believed to be involved in the concurrent use of opioids in MMT patients have been elucidated. Age of onset of opioid abuse [26], frequency of opioid use [27], peer pressure [27,28], living with family members who use heroin [29], and concomitant antiretroviral and tuberculosis treatment [27] have all been found to be positive predictors of concurrent opioid use in MMT patients.…”

Treatment adherence amongst drug users attending public and private methadone maintenance clinics in a northern province of Vietnam

“…In this study, we also found that the adherence among MMT clients was lower in the group having a history of drug injection or still used a drug when being treated with methadone. A higher level of psychological distress [47] and/or the contact with peer drug users, [18], which are considered an unproductive factor. The similarity between peers regarding drug use has been found in several studies [48,49].…”

Factors Associated with Substance Use and Sexual Behavior among Drug Users in Three Mountainous Provinces of Vietnam

“…In the cultural context of Vietnam, it is typical that injecting drug users gather in a small group and share needles [ 11 , 12 ]. Drug injection has not only driven the expansion of the HIV epidemic in the community [ 13 ], but also increased catastrophic health expenditures [ 14 ]. Scaling up the MMT program would be a cost-effective solution to reduce HIV transmission [ 15 ].…”