Methadone Maintenance Therapy in Vietnam: An Overview and Scaling-Up Plan

Vietnam is among the countries with the highest rate of HIV transmission through injecting drug users. HIV prevalence among injecting drug users is 20% and up to 50% in many provinces. An estimated number of drug users in the country by the end of 2011 were 171,000 in which the most common is heroin (85%). Detoxification at home, community, and in rehabilitation centers have been the main modalities for managing heroin addiction until Methadone Maintenance Treatment (MMT) was piloted in 2008. Recent reports have demonstrated positive treatment outcomes. Incidence of HIV was found remarkably low among patients on MMT. Treatment has significantly improved the quality of life as well as stability for society. The government has granted the Ministry of Health (MoH) to expand Methadone treatment to at least 30 provinces to provide treatment for more than 80,000 drug users by 2015. The Vietnam Administration for HIV/AIDS Control (VAAC) and MOH have outlined the role and responsibility of key departments at the central and local levels in implementing and maintaining MMT treatment. This paper will describe the achievements of the MMT pilot program and the scaling-up plan as well as strategies to ensure quality and sustainability and to overcome the challenges in the coming years. 1. Introduction As the end of May 2012, Vietnam had 171,000 registered drug users, in which 85% is Heroine users [1]. Drug use prevention and treatment has been a top priority of the Party and Government. Both supply and demand reduction programs have yielded the encouraging results. However, the achievements are just the first step, and there are many shortcomings and problems ahead. The relapse rate and number of drug-related crimes remain high. Vietnam is among the countries with the highest rate of HIV transmission through drug injection [2]. The prevalence of HIV among injecting-drug users is 20% and cases attributable to drug injection account for 60%. The current rate of HIV in IDUs has reduced but remained high in some localities, namely, Dien Bien (56%), Quang Ninh (56%), Hai Phong (48%) and Ho Chi Minh (46%), Dong Nai and Nghe An (24%), Hanoi (21%), and Lao Cai (22%) [3]. Methadone has been proved as an effective medication for opioid dependence [4]. Methadone together with psychosocial therapies and support of the family and community has helped improve the health of drug users, reduce the crimes and rate of HIV transmission and other blood-borne diseases [5]. The guidance for implementation of the Law on HIV/AIDS stipulates Methadone is one of the measures to prevent HIV