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Key findings from the WHO collaborative study on substitution therapy for opioid dependence and HIV/AIDS

ABSTRACT Aims  Opioid substitution treatment has been studied extensively in industrialized countries, but there are relatively few studies in developing/transitional countries. The aim of this study was to examine the effectiveness of opioid substitution treatment (OST) in less resourced countries....

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Published in:Addiction (Abingdon, England) England), 2008-09, Vol.103 (9), p.1484-1492
Main Authors: Lawrinson, Peter, Ali, Robert, Buavirat, Aumphornpun, Chiamwongpaet, Sithisat, Dvoryak, Sergey, Habrat, Boguslaw, Jie, Shi, Mardiati, Ratna, Mokri, Azarakhsh, Moskalewicz, Jacek, Newcombe, David, Poznyak, Vladimir, Subata, Emilis, Uchtenhagen, Ambrose, Utami, Diah S., Vial, Robyn, Zhao, Chengzheng
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cited_by cdi_FETCH-LOGICAL-c5819-3df3efd31b25fbf7e06a0f8aae8c795b9786b3fc233e76cc12b4284dce0ead753
cites cdi_FETCH-LOGICAL-c5819-3df3efd31b25fbf7e06a0f8aae8c795b9786b3fc233e76cc12b4284dce0ead753
container_end_page 1492
container_issue 9
container_start_page 1484
container_title Addiction (Abingdon, England)
container_volume 103
creator Lawrinson, Peter
Ali, Robert
Buavirat, Aumphornpun
Chiamwongpaet, Sithisat
Dvoryak, Sergey
Habrat, Boguslaw
Jie, Shi
Mardiati, Ratna
Mokri, Azarakhsh
Moskalewicz, Jacek
Newcombe, David
Poznyak, Vladimir
Subata, Emilis
Uchtenhagen, Ambrose
Utami, Diah S.
Vial, Robyn
Zhao, Chengzheng
description ABSTRACT Aims  Opioid substitution treatment has been studied extensively in industrialized countries, but there are relatively few studies in developing/transitional countries. The aim of this study was to examine the effectiveness of opioid substitution treatment (OST) in less resourced countries. Design  Longitudinal cohort study. Setting  Purposively selected OST sites in Asia (China, Indonesia, Thailand), Eastern Europe (Lithuania, Poland, Ukraine), the Middle East (Iran) and Australia. Participants  Seven hundred and twenty‐six OST entrants. Measurements  Participants were interviewed at treatment entry, 3 and 6 months. Standardized instruments assessed drug use, treatment history, physical and psychological health, quality of life, criminal involvement, blood‐borne virus (BBV) risk behaviours and prevalence of human immunodeficiency virus (HIV) and hepatitis C. Findings  Participants were predominantly male, aged in their early 30s and had attained similar levels of education. Seroprevalence rates for HIV were highest in Thailand (52%), followed by Indonesia (28%) and Iran (26%), and lowest in Australia (2.6%). Treatment retention at 6 months was uniformly high, averaging approximately 70%. All countries demonstrated significant and marked reductions in reported heroin and other illicit opioid use; HIV (and other BBV) exposure risk behaviours associated with injection drug users (IDU) and criminal activity, and demonstrated substantial improvement in their physical and mental health and general wellbeing over the course of the study. Conclusions  OST can achieve similar outcomes consistently in a culturally diverse range of settings in low‐ and middle‐income countries to those reported widely in high‐income countries. It is associated with a substantial reduction in HIV exposure risk associated with IDU across nearly all the countries. Results support the expansion of opioid substitution treatment.
doi_str_mv 10.1111/j.1360-0443.2008.02249.x
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The aim of this study was to examine the effectiveness of opioid substitution treatment (OST) in less resourced countries. Design  Longitudinal cohort study. Setting  Purposively selected OST sites in Asia (China, Indonesia, Thailand), Eastern Europe (Lithuania, Poland, Ukraine), the Middle East (Iran) and Australia. Participants  Seven hundred and twenty‐six OST entrants. Measurements  Participants were interviewed at treatment entry, 3 and 6 months. Standardized instruments assessed drug use, treatment history, physical and psychological health, quality of life, criminal involvement, blood‐borne virus (BBV) risk behaviours and prevalence of human immunodeficiency virus (HIV) and hepatitis C. Findings  Participants were predominantly male, aged in their early 30s and had attained similar levels of education. Seroprevalence rates for HIV were highest in Thailand (52%), followed by Indonesia (28%) and Iran (26%), and lowest in Australia (2.6%). Treatment retention at 6 months was uniformly high, averaging approximately 70%. All countries demonstrated significant and marked reductions in reported heroin and other illicit opioid use; HIV (and other BBV) exposure risk behaviours associated with injection drug users (IDU) and criminal activity, and demonstrated substantial improvement in their physical and mental health and general wellbeing over the course of the study. Conclusions  OST can achieve similar outcomes consistently in a culturally diverse range of settings in low‐ and middle‐income countries to those reported widely in high‐income countries. It is associated with a substantial reduction in HIV exposure risk associated with IDU across nearly all the countries. 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Treatment retention at 6 months was uniformly high, averaging approximately 70%. All countries demonstrated significant and marked reductions in reported heroin and other illicit opioid use; HIV (and other BBV) exposure risk behaviours associated with injection drug users (IDU) and criminal activity, and demonstrated substantial improvement in their physical and mental health and general wellbeing over the course of the study. Conclusions  OST can achieve similar outcomes consistently in a culturally diverse range of settings in low‐ and middle‐income countries to those reported widely in high‐income countries. It is associated with a substantial reduction in HIV exposure risk associated with IDU across nearly all the countries. 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The aim of this study was to examine the effectiveness of opioid substitution treatment (OST) in less resourced countries. Design  Longitudinal cohort study. Setting  Purposively selected OST sites in Asia (China, Indonesia, Thailand), Eastern Europe (Lithuania, Poland, Ukraine), the Middle East (Iran) and Australia. Participants  Seven hundred and twenty‐six OST entrants. Measurements  Participants were interviewed at treatment entry, 3 and 6 months. Standardized instruments assessed drug use, treatment history, physical and psychological health, quality of life, criminal involvement, blood‐borne virus (BBV) risk behaviours and prevalence of human immunodeficiency virus (HIV) and hepatitis C. Findings  Participants were predominantly male, aged in their early 30s and had attained similar levels of education. Seroprevalence rates for HIV were highest in Thailand (52%), followed by Indonesia (28%) and Iran (26%), and lowest in Australia (2.6%). Treatment retention at 6 months was uniformly high, averaging approximately 70%. All countries demonstrated significant and marked reductions in reported heroin and other illicit opioid use; HIV (and other BBV) exposure risk behaviours associated with injection drug users (IDU) and criminal activity, and demonstrated substantial improvement in their physical and mental health and general wellbeing over the course of the study. Conclusions  OST can achieve similar outcomes consistently in a culturally diverse range of settings in low‐ and middle‐income countries to those reported widely in high‐income countries. It is associated with a substantial reduction in HIV exposure risk associated with IDU across nearly all the countries. Results support the expansion of opioid substitution treatment.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>18636999</pmid><doi>10.1111/j.1360-0443.2008.02249.x</doi><tpages>9</tpages></addata></record>
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ispartof Addiction (Abingdon, England), 2008-09, Vol.103 (9), p.1484-1492
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source Applied Social Sciences Index & Abstracts (ASSIA); International Bibliography of the Social Sciences (IBSS); Wiley:Jisc Collections:Wiley Read and Publish Open Access 2024-2025 (reading list); EBSCOhost SPORTDiscus with Full Text; PAIS Index
subjects Acquired immune deficiency syndrome
Addiction
Adolescent
Adult
Aged
AIDS
Asia
Australia
Buprenorphine - administration & dosage
Care and treatment
Cross-national analysis
Developing Countries
Developing nations
Drug addiction
Drug addicts
Eastern Europe
Female
HIV
HIV Infections - complications
Human immunodeficiency virus
Humans
Intravenous drug addicts
Iran
LDCs
longitudinal
Longitudinal studies
Male
Medical treatment
Methadone
Methadone - administration & dosage
Middle Aged
multi-site study
Narcotics
Narcotics - administration & dosage
Offenders
opioid substitution therapy
Opioid-Related Disorders - complications
Opioid-Related Disorders - rehabilitation
Public health
Risk behaviour
Risk Factors
Social problems
Substance abuse treatment
treatment evaluation
Treatment Outcome
treatment outcomes
World Health Organization
title Key findings from the WHO collaborative study on substitution therapy for opioid dependence and HIV/AIDS
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