Methadone makes impressive debut in Vietnam

TN News

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Nguyen Manh Chien said he began using heroin in 1999 and failed to quit despite two different stays at rehabilitation centers.

The 41-year-old native of Hai Phong City's Le Chan Ward was using the drug four times a day, seven days a week, spending around VND200,000 each day before receiving methadone maintenance therapy (MMT) treatment as part of a pilot program that began in 2008 in Hai Phong and Ho Chi Minh cities.

After two months of treatment, Chien said he was no longer attacked by heroin cravings, and he regained seven kilograms and his normal health. He is now leading a normal life with a job at an electronics repair service.

MMT weans drug users off addiction by administering doses of methadone, an opioid that works by eliminating withrawal symptoms, reducing or eliminating cravings and blocking the euphoric effects from drug use. In Vietnam, patients visit MMT clinics everyday to have their methadone administered, and then they return to their normal lives.

Some 1,800 drug users nationwide are enrolled in the pilot program, which has been hailed as a success by both local and international experts.

Another beneficiary of the treatment, Nghia of Hai Phong's Thuy Nguyen District, also said the new therapy had helped him quit using drugs and has rid him of post-addiction cravings.

"It is really good and has helped me quit using drugs much easier than other ways," he said, adding that he had used drugs for eight years and had quit and relapsed twice before trying MMT.

"I think I can quit using drugs forever with the new therapy," he said.

Nghia also said most of those treated at the Thuy Nguyen Methadone Maintenance Treatment Clinic had happy family lives after joining the program.

Recovery

Vu Van Cong, director of Hai Phong HIV/AIDS Prevention and Control Center, said nearly one fourth of the total 754 drug users at the pilot program in Hai Phong had been able to find jobs shortly after receiving MMT treatment.

"The patients take better care of themselves and their families and they are saving money because they are no longer wasting it on drugs because they have managed to quit," he said.

He said the treatment has remarkably reduced drug rehabilitation expenses while also reducing the number of thefts and other crimes caused by drug users.

He also said methadone treatment had benefits in the health sector.

"Provision of MMT is an effective HIV prevention strategy in Vietnam given that HIV prevalence is highest among injecting drug users (IDUs) and IDUs make up the majority of people living with HIV in Vietnam," said Cong. Statistics show HIV prevalence among IDUs is highest among any segment of the population with 30 percent of IDUS having contracted the virus.

The benefits of methadone maintenance therapy were also discussed by Robert Ali of the World Health Organization's Collaborating Center at University of Adelaide in his study "Medication Assisted Therapy for Opioid Addiction around the World Impact and Lessons."

"MMT retains people in treatment, reduces opioid use, reduces mortality, reduces HIV seroconversion, reduces criminal behavior, and reduces overdose deaths," his report said.

Ali also said many Southeast Asian countries have long implemented MMT including Hong Kong since 1972, Thailand since 1979, Indonesia since 2003 and Malaysia since 2005. Good results had been seen in all countries so far, he said.

More to benefit

The Ministry of Health plans to expand MMT treatment after the initial results of the pilot program, which offered free treatment, were positive.

MMT costs approximately $1 per day per client in Vietnam, said the ministry this month in a report titled "The Effectiveness and Outcomes of the Vietnam Pilot Methadone Maintenance Therapy Treatment for Opioid Dependence."

Heroin use in patients on MMT has reduced significantly in terms of frequency and amount and there has been a reduction in HIV-risk behavior among those on MMT.

Most patients reported an improvement in terms of physical and mental health and quality of life after the treatment, the ministry said.

The ministry is now planning to provide MMT treatment for 80,000 drug dependent individuals in 30 provinces in Vietnam.

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