FHI - FHI-supported Clinics Participate in Pilot Methadone Program

MAY 2008 — After more than four years of preparatory work, methadone was administered to the first clients of an FHI-supported government clinic in Hai Phong, Vietnam, in December. Methadone treatment is now part of a comprehensive set of healthcare services provided by selected providers to reduce injection drug use and criminal activity, prevent the spread of HIV and hepatitis C, and provide treatment to HIV-positive patients.

Hai Phong has one of the highest HIV rates among injection drug users in Vietnam, with the most recent surveillance by the Ministry of Health estimating that 66 percent of them are infected. The Vietnamese government is moving toward treating heroin addiction as a disease and providing access to interventions such as methadone and drug addiction counseling for recovering heroin users to manage their addiction and integrate them back into society. This clinic will be one of the first to provide holistic services for injection drug users.

Six total clinics in the northeastern city of Hai Phong and the southeastern Ho Chi Minh City are participating in the pilot methadone program. Individuals will receive methadone maintenance therapy along with basic healthcare services, such as counseling. They will also be able to receive HIV care and treatment, including antiretroviral therapy. Besides marking USAID's first venture into methadone treatment for injection drug use, these pilot clinics are also the first community-based methadone clinics in the country.

"We are overjoyed by this accomplishment," says FHI/Vietnam Country Director Stephen Mills. "It marks the beginning of a welcomed new era in drug treatment in Vietnam."
FHI has worked closely with the Vietnamese Ministry of Health's Administration for AIDS Control on the pilot program. Key supporters include the US President's Emergency Plan for AIDS Relief via USAID and the US Centers for Disease Control and Prevention; the World Health Organization; the World Bank; and the UK Department for International Development. Representatives of these organizations were on hand for the official opening celebration for Le Chan Clinic, one of the clinics that opened in Hai Phong last Tuesday.

"FHI played an important role in making these clinics possible," says Dr Nguyen Van Vy, Director of the Hai Phong Provincial Health Service. "They were actively involved in carrying out preparatory work, collaborating closely with the Ministry of Health, local health agencies, and other stakeholders. In particular, they helped pull together appropriate trainers from around the world to provide trainings on methadone maintenance, and organized study visits for local health staff to gain experience from other countries. I am sure these activities will benefit our staff greatly during the pilot program."

Clinics will dispense methadone seven days a week, and will provide counseling and other services five days a week. After six months, FHI and PEPFAR partners will support the Ministry of Health in a preliminary evaluation to determine whether the methadone program should be scaled up throughout the country. The evaluation will provide data on methadone's impact on patients' quality of life, relapse to drug use, and other behaviors.