ArticleHarm reduction journal2017
Barriers to retention in methadone maintenance therapy among people who inject drugs in Bangkok, Thailand: a mixed-methods study.
Article in Harm reduction journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Patient experience of opioid use disorder treatment medications: a systematic review of contemporary qualitative research.BMJ open · 2024Pooled it
- Reducing perceived barriers to scaling up overdose education and naloxone distribution and medications for opioid use disorder in the United States in the HEALing (Helping End Addiction Long-Term®) communities study.Preventive medicine · 2024Trial
- Investigating the effect of zinc supplementation on probability of relapse and mental health in patients with opioid use disorder undergoing methadone maintenance treatment.Substance abuse treatment, prevention, and policy · 2023Trial
- A community approach to promote healthcare services for people living with HIV who use drugs in Vietnam.International journal of STD & AIDS · 2022Trial
- Multilevel determinants of medication preferences for opioid use disorder among criminal-legal-involved populations: Insights from a scoping review.Drug and alcohol dependence reports · 2025Review
- Optimal provision of opiate substitution therapy and needle and syringe programmes: a multi-method realist evaluation.Health technology assessment (Winchester, England) · 2025Article
- Strained patient-provider relationship, unmotivated workforce, financial constraints, and stigma: Multiple challenges in integrating mental health care within Vietnam's methadone clinics.Journal of ethnicity in substance abuse · 2025Article
- Long-Acting Buprenorphine Formulations as a New Strategy for the Treatment of Opioid Use Disorder.Journal of clinical medicine · 2023Article
- Economic, social, and clinic influences on opioid treatment program retention in Dar es Salaam, Tanzania: a qualitative study.Addiction science & clinical practice · 2023Article
- Access to needles and syringes and methadone maintenance therapy among people who inject drugs in Yangon, Myanmar: a qualitative study.Harm reduction journal · 2022Article
- The risk assessment of relapse among newly enrolled participants in methadone maintenance treatment: A group-LASSO based Bayesian network study.Frontiers in public health · 2022Article
- Pharmacogenomics biomarkers for personalized methadone maintenance treatment: The mechanism and its potential use.Bosnian journal of basic medical sciences · 2021Review
- Intersecting Stigmas among HIV-Positive People Who Inject Drugs in Vietnam.Health services insights · 2021Article
- Risky injection practices and HCV awareness in Chiang Mai Province, Thailand: a respondent-driven sampling study of people who inject drugs.BMC public health · 2020Article
- Adherence among HIV-positive injection drug users undergoing methadone treatment in Taiwan.BMC psychiatry · 2020Article
- A Scoping Review of Barriers and Facilitators to Implementation of Medications for Treatment of Opioid Use Disorder within the Criminal Justice System.The International journal on drug policy · 2020Article
- Struggling to achieve a 'normal life': A qualitative study of Vietnamese methadone patients.The International journal on drug policy · 2019Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundMethadone maintenance therapy (MMT) is a mainstay for treating opioid use disorder and preventing and managing HIV among people who inject drugs (PWID). While previous research suggested low dosing of methadone and high rates of discontinuation of MMT among PWID in Thailand, little is known about patients' lived experiences with MMT in this setting. Therefore, we conducted a mixed-methods study to examine barriers to retention in MMT among PWID in Bangkok, Thailand, with particular attention to methadone dosing.
methodsBivariate statistics were used to analyze quantitative survey data collected from methadone-treated PWID between July and October 2011. Qualitative data collected through semi-structured interviews with 16 methadone-treated PWID between July 2011 and June 2012 were analyzed thematically, with a focus on individual-level, social-structural, and environmental barriers to accessing MMT.
resultsAmong 158 survey participants, a median dosage of methadone was 30 mg/day (interquartile range 20-50). Of these, 15.8% reported having acquired street methadone due to low prescribed dosages of methadone and 19.0% reported recent syringe sharing. Qualitative interview data indicated some methadone provider-related barriers, including discouraging patients from using methadone due to it being a Western medicine, difficulty negotiating higher doses of methadone, and abrupt dose reductions without patient consultation (involving the provision of non-medicated "syrup" in some cases). Social-structural and environmental barriers to optimal MMT access included intense police surveillance of methadone clinics; and frequent incarceration of PWID and a lack of access to methadone in prisons.
conclusionsAmong our sample of methadone-treated PWID, methadone dosages were suboptimal according to the international guidelines. Poor adherence to international guidelines for opioid agonist therapies, aggressive law enforcement, and a lack of methadone in prisons need to be addressed to optimize MMT and reduce harms associated with untreated opioid use disorder in Thailand.
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