Perceived barriers to methadone maintenance treatment among Iranian opioid users

Abstract

BackgroundOpioid use is a severe problem in Iran. Despite methadone maintenance treatment (MMT) programs being one of the most important treatment strategies for reducing individual and public harms associated with opioid use, a large proportion of Iranian patients refuse to participate in such treatment programs.MethodsThe present study aims to explore the beliefs and attitudes toward MMT programs of opioid-dependent patients who were participating or had participated in methadone therapy. In-depth interviews were conducted with 23 opioid users between 27 and 58 years of age from Kurdistan provinces.ResultsOverall, six themes were discovered to be key barriers relating to methadone treatment, including financial barriers related to methadone treatment, lack of awareness about methadone treatment, negative attitudes regarding using methadone, worries about methadone’s side effects, social stigma ascribed to methadone therapy, and systemic barriers to methadone treatment.ConclusionOur study revealed that the cost of treatment is a major obstacle to attending and continuing at MMT programs and that addicts and their families are not always accurately informed about the duration of MMT programs and the side effects of methadone treatment.

Opioid agonist therapy uptake among people who inject drugs: the findings of two consecutive bio-behavioral surveillance surveys in Iran

“…Therefore, to reach and maintain the high coverage goal in all regions of the country, allocation of resources regarding the degree of inequality in the distribution of OAT services should be considered in future planning and financing of these services. In addition, addressing and removing the potential barriers to access and use of OAT such as financial barriers, lack of awareness and negative attitudes, worries about methadone's side effects, and social stigma attached to receiving OAT are integral to increasing the coverage rate of OAT uptake among Iranian PWID [8]. Tackling barriers to OAT access are of particular importance in the context of COVID-19 and future pandemics as accessing such services among PWID is often accentuated during health emergencies.…”

“…As of 2018, over 700,000 participants have received MMT programs in these centers [6]. The cost of MMT services is considerably lower in public centers [8].…”

Opioid agonist therapy uptake among people who inject drugs: The findings of two consecutive bio-behavioral surveillance surveys in Iran

“…Therefore, to reach and maintain the high coverage goal in all regions of the country, allocation of resources regarding the degree of inequality in the distribution of OAT services should be considered in future planning and nancing of these services. In addition, addressing and removing the potential barriers to access and use of OAT such as nancial barriers, lack of awareness and negative attitudes, worries about methadone's side effects, and social stigma attached to receiving OAT are integral to increasing the coverage rate of OAT uptake among Iranian PWID [8]. Comparing our results to other countries of the MENA region, the OAT uptake in Iran seems to be higher than most of its neighboring countries.…”

Opioid substitution treatment uptake among people who inject drugs: The findings of two consecutive bio-behavioral surveillance surveys in Iran

“…Therefore, to reach and maintain the high coverage goal in all regions of the country, allocation of resources regarding the degree of inequality in the distribution of OST services should be considered in future planning. In addition, addressing and removing the potential barriers to access and use of OST including financial barriers, lack of awareness and negative attitudes, worries about methadone's side effects, and social stigma attached to receiving OST is a key to increase the coverage rate of OST uptake among Iranian PWID [8]. Comparing our results to other countries of region indicate that OST uptake in Iran is still higher than most neighborhood countries in the region.…”

“…By September 2014, MMT was offered to PWID at 5744 private sector centers and 239 public sector centers supervised by State Welfare Organization, medical sciences universities, or Prisons' organization and over 700,000 participants have received MMT programs in these centers [7]. The cost of MMT services is considerably low in governmental centers [8].…”