Continue to expand the provision of multi-day methadone treatment to patients.

Facilitating access for patients

Since July 2022, Nghe An province has been piloting a multi-day methadone treatment program for opioid addicts at its treatment facilities. Dr. Tran Manh Cuong, head of the Methadone treatment facility at the Provincial Center for Disease Control, stated: In Vietnam, methadone treatment for opioid addiction has been implemented since 2008. In Nghe An, the methadone treatment program was introduced in 2012; to date, 1,162 patients have participated in treatment at 12 treatment facilities and 20 satellite dispensing centers. The effectiveness of the methadone treatment program is significant. However, the program is still not comprehensive as it requires patients to be present daily at the treatment facility to take their medication.

To help patients save time and money, and to facilitate their work and livelihood, in April 2021, the Department of HIV/AIDS Prevention and Control, Ministry of Health, implemented a pilot project to provide multi-day doses of Methadone to patients undergoing treatment for opioid addiction for home use. The first three localities to implement the program were Lai Chau, Dien Bien, and Hai Phong. By 2022, the Ministry of Health expanded the pilot program to three more localities, including Nghe An province.

To implement the program, on June 23, 2022, Nghe An province issued Plan 417/KH-UBND to pilot the multi-day Methadone dispensing program for patients undergoing opioid addiction treatment in Nghe An province in 2022. Accordingly, Nghe An has implemented the multi-day Methadone dispensing program at 12 Methadone treatment facilities in the province, including 11 facilities under the Department of Health and 1 facility under the Department of Labor, War Invalids and Social Affairs. In 2022, these 12 facilities dispensed Methadone to 185 patients (as of January 2023).

Throughout the treatment process, all patients adhered to treatment regulations and proper medication storage; there was no loss, sale, or exchange of medication. Monitoring of patients' compliance with medication use regulations at home by healthcare staff and treatment facilities was carried out effectively, ensuring the safety of patients and their families when receiving Methadone for multiple days.

It must be said that the pilot program of dispensing Methadone for multiple days to patients has met expectations and created favorable conditions for patients. Mr. NVA, 35 years old (residing in Ha Huy Tap ward, Vinh City, a patient currently receiving treatment at the Methadone facility of the Provincial Center for Disease Control) shared: “The multi-day dispensing of medication has saved us time and travel costs, making it easier for us to do business. In addition, the program has helped us overcome the stigma of being an addict, creating motivation to strive for a better life.”

The provision of Methadone for multiple days brings joy not only to patients but also to healthcare workers. Dr. Pham Ngoc Duc, in charge of the Methadone facility at the Que Phong District Health Center, said: "Implementing the Methadone treatment for multiple days increases the workload for healthcare staff at the treatment facility, making it more difficult to monitor and supervise patients. However, we are happy to see the effectiveness of the program when patients no longer abandon treatment, are more optimistic, and do not relapse into drug use. For healthcare workers, there is no greater joy than seeing the health of patients improve and be ensured."

Methadone is an opioid used as a substitute for narcotics, especially heroin, in addiction treatment programs. For addicts, taking methadone reduces cravings, improves overall health, enhances social security and order, contributes to family economic development, and aids in physical and mental recovery.

Expanding and improving the quality of treatment.

To further facilitate patients' access to and improve the quality of opioid addiction treatment services using Methadone, contributing to reducing HIV transmission, improving health and quality of life, on September 18, 2023, the People's Committee of Nghe An province issued Plan No. 684/KH-UBND to implement the provision of multi-day Methadone treatment for patients with opioid addiction in the province, for the period 2023-2024.

Accordingly, in the two years 2023-2024, Nghe An will continue to maintain the multi-day Methadone dispensing program at the 12 Methadone treatment facilities that were established in 2022, including 11 facilities under the Department of Health and 1 facility under the Department of Labor, War Invalids and Social Affairs; and expand the multi-day Methadone dispensing program to 18 dispensing facilities throughout the province (the two Methadone dispensing facilities at Nghia Dan and Nghi Loc District Health Centers, which currently have no patients, will be implemented depending on the actual situation).

Methadone is guaranteed from the province's Methadone supply, purchased with local budget funds. Supplies for the program, such as medication bottles, bags, and current dispensing tracking numbers, are secured from Global Fund Project funding… The number of people expected to receive multi-day Methadone treatment in 2023 is 595; and in 2024 is 1,035.

The People's Committee of Nghe An province clearly assigns responsibilities and requires relevant departments, localities, and units to strengthen various forms of monitoring the use of Methadone by patients through different channels, both direct and indirect, during the process of patients taking the medication home for use; and to strictly handle cases of violations during the dispensing of Methadone over several days.

Dr. Chu Trong Trang, Director of the Provincial Center for Disease Control, stated: The Provincial Center for Disease Control has been assigned as the permanent unit and focal point for the implementation of multi-day Methadone distribution. Immediately after receiving the plan from the Provincial People's Committee, the center promptly sent a document to the health centers of districts, towns, and Vinh City, as well as the province's voluntary drug rehabilitation centers, to review, develop plans, and implement multi-day drug distribution for patients who meet the conditions according to the Ministry of Health's guidelines. After nearly a month of implementation, 112 patients have received multi-day Methadone treatment, and are currently awaiting supplies from the central government to expand the number of patients.

At this time, as they continue to receive long-term medication, all patients participating in the program express their gratitude for the attention and support they have received from the Ministry of Health and the province. Mr. LTK (Dong Van commune, Que Phong district) expressed: "We are very grateful to the government for its attention and support in allowing us to receive Methadone treatment and long-term medication. Our lives and work are better now that we don't have to go to get our medication every day."