Struggling to achieve a 'normal life': A qualitative study of Vietnamese methadone patients.
Addiction
HIV
Heroin
Methadone
Vietnam
Journal
The International journal on drug policy
ISSN: 1873-4758
Titre abrégé: Int J Drug Policy
Pays: Netherlands
ID NLM: 9014759
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
27
08
2018
revised:
27
02
2019
accepted:
11
03
2019
pubmed:
13
4
2019
medline:
24
3
2020
entrez:
13
4
2019
Statut:
ppublish
Résumé
Methadone maintenance treatment, initially introduced in Vietnam for HIV harm reduction, has marked a significant switch in the country's drug policy - from addiction as a moral issue to addiction as a brain disease. After the some initial outstanding achievements, the programme is facing a high dropout rate that threatens both goals of HIV prevention and drug treatment. This sociological study, as part of an HIV intervention research project, explores the challenges and opportunities that individuals who use drugs are faced with in relation to addiction treatment. A qualitative study among drug users with and without methadone maintenance treatment experiences recruited by peer outreach workers. We conducted 58 in-depth interviews and 2 focus groups between 2016 and 2017. The start of treatment brought about significant feelings of success as heroin use was no longer compulsive. However, being in treatment programmes is also challenging with respect to continuing the recovery process. Barriers to retention include a popular fear of methadone as another harmful drug, a feeling of dependence related to the current practices of methadone treatment programmes and a poor therapeutic relationship. In the face of such challenges, the two major motivations that keep patients in care come from the desire to completely break up with heroin and the pursuit of family happiness. The current practices of methadone programmes pose challenges to patients' recovery efforts from addiction and threaten treatment retention. Prompt interventions are needed to help Vietnam attain its objective of providing better care for larger vulnerable populations.
Sections du résumé
BACKGROUND
Methadone maintenance treatment, initially introduced in Vietnam for HIV harm reduction, has marked a significant switch in the country's drug policy - from addiction as a moral issue to addiction as a brain disease. After the some initial outstanding achievements, the programme is facing a high dropout rate that threatens both goals of HIV prevention and drug treatment. This sociological study, as part of an HIV intervention research project, explores the challenges and opportunities that individuals who use drugs are faced with in relation to addiction treatment.
METHODS
A qualitative study among drug users with and without methadone maintenance treatment experiences recruited by peer outreach workers. We conducted 58 in-depth interviews and 2 focus groups between 2016 and 2017.
RESULTS
The start of treatment brought about significant feelings of success as heroin use was no longer compulsive. However, being in treatment programmes is also challenging with respect to continuing the recovery process. Barriers to retention include a popular fear of methadone as another harmful drug, a feeling of dependence related to the current practices of methadone treatment programmes and a poor therapeutic relationship. In the face of such challenges, the two major motivations that keep patients in care come from the desire to completely break up with heroin and the pursuit of family happiness.
CONCLUSION
The current practices of methadone programmes pose challenges to patients' recovery efforts from addiction and threaten treatment retention. Prompt interventions are needed to help Vietnam attain its objective of providing better care for larger vulnerable populations.
Identifiants
pubmed: 30978641
pii: S0955-3959(19)30092-1
doi: 10.1016/j.drugpo.2019.03.026
pmc: PMC6535358
mid: NIHMS1526699
pii:
doi:
Substances chimiques
Methadone
UC6VBE7V1Z
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
18-26Subventions
Organisme : NIDA NIH HHS
ID : R01 DA041978
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.
Références
BMC Psychiatry. 2012 Dec 28;12:238
pubmed: 23270305
J Public Health Policy. 2018 May;39(2):217-230
pubmed: 29531303
J Urban Health. 2005 Jun;82(2):250-66
pubmed: 15872194
Int J Drug Policy. 2013 Nov;24(6):e1-5
pubmed: 24075399
Harm Reduct J. 2017 Sep 7;14(1):63
pubmed: 28882155
Psychol Addict Behav. 2015 Dec;29(4):906-17
pubmed: 26098127
AIDS Care. 2016 Oct;28(10):1312-5
pubmed: 27178119
Glob Public Health. 2013;8 Suppl 1:S75-91
pubmed: 23363324
Harm Reduct J. 2017 Aug 30;14(1):59
pubmed: 28854943
Drugs (Abingdon Engl). 2015;22(3):255-262
pubmed: 27087758
Int J Drug Policy. 2009 Jan;20(1):1-3
pubmed: 18775657
Addiction. 2008 Apr;103(4):535-43
pubmed: 18261190
Int J Epidemiol. 2010 Dec;39 Suppl 2:ii29-37
pubmed: 21113034
Cult Med Psychiatry. 2000 Jun;24(2):165-95
pubmed: 10885786
Subst Use Misuse. 2011;46(9):1190-8
pubmed: 21417558
J Psychoactive Drugs. 2009 Sep;41(3):285-96
pubmed: 19999682
Glob Public Health. 2007;2(2):125-39
pubmed: 19280395
Soc Sci Med. 2018 Mar;201:71-79
pubmed: 29455053
Int J Drug Policy. 2018 Jun;56:208-217
pubmed: 29754895
Int J Qual Stud Health Well-being. 2016 Oct 19;11:31992
pubmed: 27765141
J Psychoactive Drugs. 2011 Apr-Jun;43(2):99-107
pubmed: 21858956
J Public Health Res. 2014 Mar 26;3(1):204
pubmed: 25170509
Psychiatr Serv. 2014 Feb 1;65(2):146-57
pubmed: 24248468
N Engl J Med. 2014 May 29;370(22):2063-6
pubmed: 24758595
Lancet. 2010 Jul 31;376(9738):355-66
pubmed: 20650513
Int J Drug Policy. 2014 Jan;25(1):53-60
pubmed: 24113623
Qual Health Res. 2013 Jul;23(7):951-62
pubmed: 23649657
Int J Nurs Stud. 2011 Oct;48(10):1244-57
pubmed: 21481390
Glob Public Health. 2015;10(7):867-80
pubmed: 26089184
BMJ Open. 2015 Jan 08;5(1):e005997
pubmed: 25573521
Int J Drug Policy. 2013 Nov;24(6):e43-50
pubmed: 23199896
Soc Stud Sci. 2002 Feb;32(1):93-135
pubmed: 12051261
J Subst Abuse Treat. 2016 Jul;66:37-47
pubmed: 27211995
BMC Psychol. 2014 Sep 07;2(1):26
pubmed: 25566385
Bull World Health Organ. 2013 Jul 1;91(7):475-82
pubmed: 23825874
PLoS One. 2013 Jul 26;8(7):e68906
pubmed: 23922668
Qual Health Res. 2012 Jun;22(6):810-24
pubmed: 22232295
J Subst Abuse Treat. 2010 Mar;38(2):119-27
pubmed: 20015606