Evaluation of Methadone Maintenance Treatment in Armenia, Colombia: A Cross-sectional Study Responding to a National Priority

Abstract

Colombia has experienced a dramatic increase of heroin use in the last 3 decades, stablishing the first methadone maintenance treatment (MMT) program in 2004. Although international evidence indicates that MMT has important benefits for people with opioid use disorder, technical and logistical difficulties have been identified in Colombia that can compromise the effectiveness of this treatment modality. In this cross-sectional study, a total of 148 subjects with opioid use disorder were interviewed in the city of Armenia (Colombia) using the Opiate Treatment Index, comparing the drug use, social functioning, human immunodeficiency virus risk behaviors, criminal activity, and the physical/mental health among subjects involved in MMT and those not receiving treatment. Despite the above-mentioned difficulties, subjects participating in MMT reported less illegal substance use (specifically heroin and basuco), less human immunodeficiency virus risk behaviors, better social functioning, less criminal activity, and less physical and mental health problems than those not receiving treatment. In addition, subjects involved in MMT reported a daily use of heroin and lower than recommended dosages of methadone. Therefore, Colombia should continue expanding MMT programs across the country, integrating the available harm reduction strategies and providing continuous training for health professionals in charge of these programs.

Mental health services implementation in Colombia – a systematic review

“…We report on our findings using the broad structure of the CFIR (constructs and domains) complemented with the selected factors of the Socio-Political Economy of Global Mental Health framework. Studies were supported by primary systematic reviews, national public surveys like the National Mental Health Survey in 2015 (83,84) and previous international studies with notable performance results in similar settings (82,85,86).…”

“…Studies were supported by primary systematic reviews, national public surveys like the National Mental Health Survey in 2015 (83,84) and previous international studies with notable performance results in similar settings (82,85,86).…”

“…Precise design and assembling promote accessibility for users, facilitating adaptation and future implementation (121). However, regarding how the interventions were designed and presented, many did not report toolkits or material used to support implementation.…”

“…Therefore, it is necessary to increase the collaboration between insurers, providers, researchers, policymakers, police bodies and law entities such as The Ministry of Justice. Hence, Colombia will address the emerging consumption phenomenon and its consequences (85,88).…”

“…Only a few studies stated that outside actors backed them. Supporters included police forces, students, and official health officers (77,85,91,93).…”