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...

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Autores principales: Reid, Gary, Sharma, Mukta, Higgs, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: PAGEPress Publications, Pavia, Italy 2014
Materias:
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
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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.
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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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