Singh P M, Shrestha D M, Bhandari G P
Nepal Med Coll J. 2014 Sep;16(1):17-9.
Methadone maintenance therapy is widely accepted form of substitution therapy in people with Opioid dependent client. It is a kind of harm reduction strategy which prevents the spread of HIV and hepatitis among injecting drug users. It also improves quality of life and help decrease crime and other social issues. The program has been in Nepal for few years. The clients are increasing more each day and the demand for the program is also increasing. There is an urgent need of scaling-up the program in Nepal to address the increasing number of clients and unreached clients. This is an attempt to assess qualitatively the methadone maintenance therapy program in Nepal to generate evidences as a support to existing programs and to scale up the program in unreached population. The qualitative study revealed that the clients had adequate knowledge on the program and the program is quite satisfactory. However, they have to wait for a long to get enrollment in the program, there is no counseling session and they were more concern about the quality of the drug. Despite many lacunae, the participants found the program very useful in terms of developing good relation with family members, decreasing the necessity of money, being able to attend social functions, health and economic benefits, time saving, easily getting job. On the other hand, they were experiencing adverse effect such as decreasing sexual performance, dental caries, nausea, social stigma due to misuse of the program by some clients which are not properly addressed by the program. The program can be improved by making it priority problem at national level by the government, improving it as one stop shopping such as providing counseling, medicine and skill development program at one place.
美沙酮维持治疗是阿片类药物依赖者广泛接受的替代治疗形式。它是一种减少伤害的策略，可防止艾滋病毒和肝炎在注射吸毒者中传播。它还能改善生活质量，并有助于减少犯罪和其他社会问题。该项目在尼泊尔开展已有数年。客户数量每天都在增加，对该项目的需求也在增加。尼泊尔迫切需要扩大该项目，以应对不断增加的客户数量和未覆盖的客户群体。这是一次对尼泊尔美沙酮维持治疗项目进行定性评估的尝试，旨在生成证据，以支持现有项目，并在未覆盖人群中扩大该项目。定性研究表明，客户对该项目有足够的了解，并且该项目相当令人满意。然而，他们要等待很长时间才能加入该项目，没有咨询环节，而且他们更担心药物质量。尽管存在许多缺陷，但参与者发现该项目在与家庭成员建立良好关系、减少对金钱的需求、能够参加社交活动、健康和经济效益、节省时间、容易找到工作等方面非常有用。另一方面，他们也在经历一些不良影响，如性功能下降、龋齿、恶心，以及由于一些客户滥用该项目而导致的社会耻辱感，而该项目并未妥善解决这些问题。该项目可以通过政府将其作为国家层面的优先问题来改善，将其改进为一站式服务，例如在一个地方提供咨询、药物和技能发展项目。
