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

• Published in: BMJ open 2018-03, Vol.8 (3), p.e015875-e015875
• Main Authors: Tran, Bach Xuan, Boggiano, Victoria L, Thi Nguyen, Huong Lan, Nguyen, Long Hoang, Nguyen, Hung Van, Hoang, Canh Dinh, Le, Huong Thi, Tran, Tho Dinh, Le, Hai Quan, Latkin, Carl A, Thi Vu, Thuc Minh, Zhang, Melvyn WB, Ho, Roger CM
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; Analgesics, Opioid - therapeutic use; Cross-Sectional Studies; Drug use; Heroin; HIV; Human immunodeficiency virus; Humans; Logistic Models; Low income groups; Male; Medication Adherence; Methadone; Methadone - therapeutic use; Opiate Substitution Treatment; Opioid-Related Disorders - drug therapy; Opioid-Related Disorders - epidemiology; Psychiatric Status Rating Scales; Public Health; Quality of Life; Severity of Illness Index; Social Class; Surveys and Questionnaires; Vietnam - epidemiology; Young Adult
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2017-015875

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.