Author: Dr. Diep Nguyen
Introduction
This scoping review aims to provide a comprehensive overview of the accomplishments and areas requiring improvement in the Methadone Maintenance Treatment (MMT) program in Vietnam after 15 years of implementation.
Methods
A scoping review was conducted, drawing insights from international and national peer-reviewed journals, national conference proceedings, and post-graduate theses. Two independent reviewers employed pretested forms to select and characterize the relevant studies. The results are categorized into four main topics: (1) patient outcomes, (2) program implementation, (3) social aspects and policies, and (4) cost-effectiveness.
Results
The scoping review encompassed 103 publications and 10 theses with diverse study designs, including cross-sectional, qualitative, intervention, and longitudinal studies. Notable achievements were observed in the reduction of drug use, criminal activities, and the enhancement of physical and mental health among methadone patients. Furthermore, there was a decrease in risk behaviors related to HIV and STDs, improved social functioning and quality of life. The decentralized and integrated model contributed to improved access to care, yet high dropout rates persisted due to persistent stigma associated with drug use history and methadone treatment, along with stringent drug policies. Economically, methadone patients exhibited lower insurance coverage compared to HIV patients on Antiretroviral Therapy (ART), with a reluctance to bear costs. Despite these challenges, the program demonstrated better cost-effectiveness than other interventions, such as rehabilitation centers.
Conclusion
The Methadone Maintenance Treatment program in Vietnam has achieved significant success in reducing illegal drug use, stabilizing psychological well-being, and facilitating community reintegration. This scoping review highlights the necessity for further research to explore and address the implementation challenges, emphasizing the importance of interventions to enhance the program's effectiveness.