The Long Winding Road of Opioid Substitution Therapy Implementation in South-East Asia: Challenges to Scale Up
The South-East Asia Region contains an estimated 400,000-500,000 people who inject drugs (PWID). HIV prevalence among PWID is commonly 20% or higher in Indonesia, Thailand, Myanmar and some regions of India. Opioid substitution therapy (OST) is an important HIV prevention intervention in this part o...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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PAGEPress Publications, Pavia, Italy
2014
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140379/ https://www.ncbi.nlm.nih.gov/pubmed/25170509 http://dx.doi.org/10.4081/jphr.2014.204 |
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author | Reid, Gary Sharma, Mukta Higgs, Peter |
author_facet | Reid, Gary Sharma, Mukta Higgs, Peter |
author_sort | Reid, Gary |
collection | PubMed |
description | The South-East Asia Region contains an estimated 400,000-500,000 people who inject drugs (PWID). HIV prevalence among PWID is commonly 20% or higher in Indonesia, Thailand, Myanmar and some regions of India. Opioid substitution therapy (OST) is an important HIV prevention intervention in this part of the world. However, key challenges and barriers to scale up of OST exist, including: pervasive stigma and discrimination towards PWID; criminalisation of drug use overshadowing a public health response; lack of political will and national commitment; low financial investment; focus towards traditional treatment models of detoxification and rehabilitation; inadequate dosing of OST; and poor monitoring and evaluation of programmes. Our review of local evidence highlights that OST can be successful within the Asian context. Such evidence should be utilised more widely to advocate for policy change and increased political commitment to ensure OST reaches substantially more drug users. |
format | Online Article Text |
id | pubmed-4140379 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | PAGEPress Publications, Pavia, Italy |
record_format | MEDLINE/PubMed |
spelling | pubmed-41403792014-08-28 The Long Winding Road of Opioid Substitution Therapy Implementation in South-East Asia: Challenges to Scale Up Reid, Gary Sharma, Mukta Higgs, Peter J Public Health Res Review and Meta-Analysis The South-East Asia Region contains an estimated 400,000-500,000 people who inject drugs (PWID). HIV prevalence among PWID is commonly 20% or higher in Indonesia, Thailand, Myanmar and some regions of India. Opioid substitution therapy (OST) is an important HIV prevention intervention in this part of the world. However, key challenges and barriers to scale up of OST exist, including: pervasive stigma and discrimination towards PWID; criminalisation of drug use overshadowing a public health response; lack of political will and national commitment; low financial investment; focus towards traditional treatment models of detoxification and rehabilitation; inadequate dosing of OST; and poor monitoring and evaluation of programmes. Our review of local evidence highlights that OST can be successful within the Asian context. Such evidence should be utilised more widely to advocate for policy change and increased political commitment to ensure OST reaches substantially more drug users. PAGEPress Publications, Pavia, Italy 2014-03-26 /pmc/articles/PMC4140379/ /pubmed/25170509 http://dx.doi.org/10.4081/jphr.2014.204 Text en ©Copyright G. Reid et al., 2014 http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review and Meta-Analysis Reid, Gary Sharma, Mukta Higgs, Peter The Long Winding Road of Opioid Substitution Therapy Implementation in South-East Asia: Challenges to Scale Up |
title | The Long Winding Road of Opioid Substitution Therapy Implementation in South-East Asia: Challenges to Scale Up |
title_full | The Long Winding Road of Opioid Substitution Therapy Implementation in South-East Asia: Challenges to Scale Up |
title_fullStr | The Long Winding Road of Opioid Substitution Therapy Implementation in South-East Asia: Challenges to Scale Up |
title_full_unstemmed | The Long Winding Road of Opioid Substitution Therapy Implementation in South-East Asia: Challenges to Scale Up |
title_short | The Long Winding Road of Opioid Substitution Therapy Implementation in South-East Asia: Challenges to Scale Up |
title_sort | long winding road of opioid substitution therapy implementation in south-east asia: challenges to scale up |
topic | Review and Meta-Analysis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140379/ https://www.ncbi.nlm.nih.gov/pubmed/25170509 http://dx.doi.org/10.4081/jphr.2014.204 |
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