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ID: 1083

Type of submission: Oral

Conference track: Practice

Topics: Opioid Substitution Therapy Programmes

Presenting author: Wai Linn

Presenting author biography:

I am a medical doctor and presently working in Asian Harm Reduction Network - Myanmar (INGO) which is a leading agency delivering harm reduction services in hot-spot areas residing people who inject drugs in Myanmar. My title is Medical Coordinator (MMT), focal person for methadone maintenance program.

It is time! Methadone Maintenance Therapy (MMT) take-home prescription would improve thousands’ life in Myanmar

Wai Linn, Aung Yu Naing

MMT aims to stabilize people from opioid dependence while leading productive lives. However, almost 60% of MMT clients in Hpakant City, infamous for drugs and jade, faced with low income and uncertain work conditions are unable to abide to daily supervised intake. Consequently clients drop out or tail off MMT too fast. Alcohol, ATS… then often becomes the replacement with enhanced risks of poly drug use.

Seng Taung, part of Myanmar’s Hpakant City, has long been notorious for high rates of drug use and HIV infection. Living conditions in this remote, mountainous area are extremely tough. MMT clients spend considerable time & transport expenses for daily methadone intake and this negatively affects employment possibilities.

Since April 2013, AHRN Myanmar assists National Drug Abuse Prevention and Control Program in operating MMT clinics. To address the barrier of daily supervision, take-home prescriptions up to maximum 7 days are initiated after assessing the client’s stability, adherence, social conditions, employment and risk of poly drug use/misuse. The assessment is done either individually or through case meetings. Family members are invited for counseling to enhance their responsibility and support in securing the take-home doses. The progress is monitored individually on weekly basis and follow-up is done.

Up to September 2016, there were 607 MMTclients; 70 received take-home doses regularly. 60% (42/70) were getting monthly income (~ $250), 0% drop out from MMT within 6 months. 80% (56/70) tested negative for heroin based on random urine tests. Only 3 cases of misuse (methadone sold in the black market) were noticed. MMT clients and families acknowledge that take-home doses are beneficial in stabilizing their lives and integrate them again into the family, community while maintaining employment by freeing them from the demands of travel for daily supervised dosing.