scholarly journals Substance Use and The Necessity for Harm Reduction Programs in Prisons: A Qualitative Study in Central Prison of Sanandaj, Iran

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mohammad Bagher Saberi Zafarghandi ◽  
Sahar Eshrati ◽  
Reza Arezoomandan ◽  
Marziyeh Farnia
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Harm Reduction ◽  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Antiretroviral Treatment ◽  
Service Providers ◽  
Methadone Maintenance ◽  
Opioid Substitution Therapy ◽  
Self Injury

Background: For decades, harm reduction programs for addiction have been started in Iranian prisons. The programs comprise methadone maintenance treatment, antiretroviral treatment, and other harm reduction programs implemented as a triangular clinic. Despite the lack of funding to provide mental health services, particularly for substance use and harm reduction in prisons of low- and middle-income countries, Iran provides well-developed services. Objectives: The study investigated the implementation and achievements of harm reduction programs in Sanandaj prison located in the center of Kurdistan Province, west of Iran. Methods: This was a qualitative cross-sectional study. We used various information sources such as a checklist and group discussions. The participants were chosen by the purposive sample method and included prison authorities and harm reduction service providers and recipients. The data were analyzed by content analysis. Results: The harm reduction programs included opioid substitution therapy, providing information and education, voluntary counseling and testing for blood-borne diseases, providing condoms, hepatitis C virus screening, and antiretroviral treatment. Following the implementation of the program, a significant decrease in violence, self-injury, illegal drug use and shared syringes, HIV-positive new comers, and no necessity for the needle and syringe program when starting methadone treatment was reported. Conclusions: Commitment to a strict ban on the entering of drugs to the prison is a reason for the use of high-risk methods of drug use and behaviors such as injection, self-injury, or violence. Sharing syringes and needles is a major cause of the transmission of HIV and hepatitis viruses among drug users. Harm reduction programs, especially methadone maintenance treatment and antiretroviral treatment, have reduced a large proportion of drug-related harms in prisons. Scaling up the programs and their extension to post-release treatment will greatly reduce the country's health costs.

scholarly journals Faktor-Faktor yang Mempengaruhi Pengguna Napza Suntik dalam Tindakan Pemanfaatan Layanan Program Terapi Rumatan Methadon (PTRM) di Kota Cirebon

2016 ◽  
Vol 11 (2) ◽  
pp. 18
Author(s):  
Dessy Aryanti ◽  
Bagoes Widjanarko ◽  
Kusyogo Cahyo
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Treatment Program ◽  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Health Workers ◽  
Methadone Maintenance ◽  
Family Attitudes ◽  
Methadone Maintenance Treatment Program ◽  
Hiv Aids

ABSTRACTAccording to the risk factors as a result of injecting drug use (IDU) were second highest, after the heterosexual and homo-bisexual. In IDUs face two risks for contracting HIV / AIDS, from the use of unsterilized needles and performed together or alternately with other IDUs and also through sexual intercourse, especially that done with more than one partner without using a condom. Methadone maintenance treatment program (PTRM) is included in the Harm Reduction program – This is a program of harm reduction drug use in preventing transmission of HIV / AIDS. This research is quantitative with correlational design, sampling using the technique across sectional the total population 50 person IDUs of injecting drug users in the city of Cirebon -use structured questionnaires technique. From the 50 IDUs who were respondents in this research note that 68% did not use PTRM services. It is because most IDUs still can not stop using injection drugs and have not been willing to switch to PTRM. Results of univariate analysis to determine the level of knowledge of IDUs about PTRM 88% have a good category, the attitude of the respondents 80% have category support PTRM, family attitudes 50% have category support PTRM, attitudes of peers 72% have a category does not support the utilizations PTRM, attitude of health workers 66% category does not support PTRM, and the availability of facilities and health facilities 52% support in PTRM services. For the bivariate analysis showed that the attitude of IDUs to program substitution therapy methadone-related measures the utilization of PTRM, whereas knowledge factors, family attitudes, attitudes of peers, attitude of health workers, and the availability of facilities. Then knowledge of IDUs about PTRM shows no relationship with the actions the utilization of PTRM , And based on multivariate analysis known that the action the utilization of PTRM is influenced by the family attitudes were supportive of the utilizations of Methadone maintenance treatment program (PTRM).Keywords: drug, injection, PTRM, HIV/AIDS

Predictors of Positive Outcomes for Out-of-Treatment Opiate Injectors Recruited into Methadone Maintenance through Street Outreach

2002 ◽  
Vol 32 (3) ◽  
pp. 999-1016 ◽  
Author(s):  
Karen Fortuin Corsi ◽  
Carol F. Kwiatkowski ◽  
Robert E. Booth
Keyword(s):  
Drug Use ◽  
Behavior Change ◽  
Hiv Risk ◽  
Methadone Maintenance Treatment ◽  
Injection Drug Users ◽  
Drug Users ◽  
Maintenance Treatment ◽  
Methadone Maintenance ◽  
Positive Outcomes

This study was conducted to assess behavior change in the areas of drug use, productivity, criminal activity, and HIV risk among street-recruited injection drug users who entered methadone maintenance treatment. In addition, the study examined a number of variables that could account for these changes, including demographics, intervention effects, and treatment-related measures. A total of 168 participants were interviewed at baseline, received outreach interventions, entered methadone maintenance treatment, and were reinterviewed 5–9 months later. Significant (p<.001) improvements were seen in the areas of drug use, productivity, criminality, and HIV risk behaviors. The only variables significantly associated with behavior change were related to drug treatment. In particular, being in treatment at the time of the follow-up assessment had the strongest relationship to positive outcomes, including length of treatment. Having no prior treatment experience was associated with fewer injections at follow-up. These findings emphasize the importance of retaining clients, given the likelihood that positive change is likely to be evidenced while they remain in treatment

scholarly journals Perceptions of Problem Gambling Among Methadone Maintenance Treatment Clients and Counsellors

2018 ◽  
Author(s):  
Megan E Wall ◽  
Cassandra R Durand ◽  
Hana Machover ◽  
Rachel Arnold ◽  
Haley A Miles-McLean ◽  
...  
Keyword(s):  
Substance Use ◽  
Problem Gambling ◽  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Methadone Maintenance ◽  
Negative Impact ◽  
Treatment Options ◽  
Current Treatment ◽  
Treatment Programs ◽  
Structured Interviews

Problem gambling is highly prevalent and rarely treated among clients who attend methadone maintenance treatment programs (MMTPs). Compared with those of the general population, rates of gambling disorder have been found to be elevated among individuals receiving methadone maintenance treatment. Our study aims were to (a) develop a clearer understanding of the gambling experience of clients and counsellors at a methadone clinic and (b) gain insight into the current treatment options and obstacles to treatment in the clinic. Semi-structured interviews focusing on gambling issues were conducted with 8 clients and 8 counsellors at an MMTP located in an urban area. Participants were asked questions to gain an understanding about their perspectives on, treatment options for, and treatment barriers to problem gambling in the clinic. Data were coded by 4 investigators by using a constant comparison, open coding approach. The findings revealed important differences between clients and counsellors: Opinions differed on the definition of problem gambling, obstacles to treatment, and optimal treatment settings. Clients and counsellors also agreed on some elements, including the negative impact that problem gambling can have on recovery from substance use. This examination of responses of counsellors and client feedback provides a useful mechanism to better understand problem gambling in MMTPs.  In addition, the findings have important clinical implications, including a need for more effective screening and treatment in MMTPs and to provide substance use counsellors with training related to problem gambling.RésuméLe jeu compulsif est hautement répandu et rarement traité parmi les clients qui suivent un programme de traitement d’entretien à la méthadone. Comparés à ceux de la population en général, les taux de jeu pathologique ont jugé élevés chez les personnes qui suivent un tel traitement. Les objectifs de notre étude étaient de deux ordres : a) mieux comprendre l’expérience de jeu des clients et les connaissances en cette matière des conseillers d’une clinique de traitement à la méthadone, et b) avoir une meilleure compréhension des options de traitement actuelles et des obstacles au traitement en clinique. Des entretiens semi-structurés portant sur les problèmes de jeu ont été menés auprès de 8 clients et de 8 conseillers dans un centre de traitement, situé en zone urbaine. On a posé des questions aux participants pour mieux comprendre leurs points de vue sur les options et les obstacles au traitement contre le jeu problématique à la clinique. Les données ont été codées par quatre chercheurs en utilisant une approche de codification ouverte à comparaison constante. Les résultats ont révélé des différences importantes entre les clients et les conseillers : les opinions divergeaient quant à la définition du jeu problématique, les obstacles au traitement et les paramètres de traitement optimaux. Les clients et les conseillers ont par ailleurs été d’accord sur certains éléments, notamment l’impact négatif que le jeu problématique peut avoir sur le rétablissement d’une consommation abusive. L’examen des réponses des conseillers et des commentaires des clients constitue un mécanisme efficace pour mieux comprendre le jeu problématique dans les programmes de traitement d’entretien à la méthadone. De plus, les résultats ont d’importantes répercussions cliniques, notamment la nécessité d’un dépistage et d’un traitement d’entretien à la méthadone plus efficaces et d’une formation sur le jeu problématique pour les conseillers en toxicomanie. 

scholarly journals Aproximacions a la perspectiva de la persona en tractament de manteniment amb metadona: Reflexions a propòsit de 10 anys de recerca / Approaches to the perspective of the individual receiving methadone maintenance treatment: Reflections on 10 years of research

2017 ◽  
Vol 35 (2) ◽  
pp. 39-50
Author(s):  
Joan Trujols Albet ◽  
Joan Guàrdia-Olmos ◽  
Ioseba Iraugui ◽  
José Pérez de los Cobos
Keyword(s):  
Harm Reduction ◽  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Methadone Maintenance ◽  
Heroin Dependence ◽  
Psychopharmacological Treatment ◽  
Harm Reduction Intervention ◽  
The Individual

 Resum. Els tractaments de manteniment amb metadona (TMM) són un autèntic tractament psicofarmacològic de la dependència d’heroïna i, a la vegada, un element indispensable de les polítiques i les intervencions de reducció de danys. L’efectivitat dels TMM ha estat avaluada, gairebé de manera exclusiva, mitjançant la utilització d’indicadors anomenats durs. Intentant anar més enllà d’aquest enfocament tradicional, hem portat a terme, durant els darrers 10 anys, diversos estudis emprírics i assaigs teòrics que s’emmarquen dins d’un objectiu global de generar coneixement al voltant de  –i amb– la perspectiva de la persona en TMM. En aquest article, resumim de manera selectiva les troballes més rellevants d’aquesta línia de recerca per discutir després algunes de les seves principals implicacions. Finalment, abordem alguns dels reptes  –i suggerim alguns dels canvis necessaris– per a una avaluació dels TMM realment centrada en el pacient.Summary. Methadone maintenance treatment (MMT) is both a specific psychopharmacological treatment of heroin dependence and a core harm-reduction intervention. Over the last 10 years we have been working to break the mould of the traditional focus on the so-called hard indicators of MMT effectiveness, pursuing instead a line of research that makes room for the consideration of the perspectives of methadone-maintained patients, resulting in several empirical and theoretical papers. Firstly, this commentary briefly and selectively summarizes some key findings from five of these papers. It then discusses the main implications of these findings. Finally, it addresses some of the challenges involved in conducting a genuinely patient-centred evaluation of MMT, along with some of the changes that would be required to accomplish this.

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