India: Methadone treatment welcomed by drug using community
It is a well known fact that illicit drug use is a significant problem in India. According to reports from the National AIDS Control Organization, Government of India there are approximately 177,000 injecting drug users in India. HIV prevalence among them is 7.2 percent. Repeated drug use can lead to dependence, which globally has been recognised as a chronic relapsing health condition akin to other non-communicable diseases like hypertension and diabetes. Like other patients of non-communicable diseases, drug dependent individuals also require long-term medical treatment.
Methadone maintenance treatment (MMT) is a universally accepted treatment option for those dependent on opioid drugs. MMT improves the well-being and social functioning of drug users. It reduces morbidity and mortality caused by the use of illicit opioids, such as Hepatitis and HIV, and it also improves physical and psychological health. The user experiences neither cravings nor withdrawals when on MMT and is able to reintegrate into society.
In order to be able to offer MMT as a treatment option to drug users, the United Nations Office on Drugs and Crime, in collaboration with the National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences, (AIIMS), New Delhi initiated a pilot project in India. The project aimed at testing the effectiveness and feasibly of MMT in the Indian context and developed an action plan for rolling out the MMT programme.
After 18 months of implementation, UNODC together with NDDTC disseminated the findings of this pilot project at a special event in New Delhi. Medical staff from the five implementing partners shared their experience. They all found that MMT had been successful in reducing drug use and injecting habits amongst drug users. The retention rate across all participating centres was a commendable 36 percent and MMT was well received by drug users and their family members as a treatment option. Medical staff found Methadone easy to dispense with minimal side effects and no incidents of overdose.
Representatives from the Ministry of Health, Government of India, National AIDS Control Organization, Government of India, implementing partners from 5 sites across India, United Nations and the media attended the event, where Shri Oscar Fernandes, Union Minister for Transport, Road and Highways and Convener of the Parliamentary Forum on HIV/AIDS was the chief guest.
Mr. Shailendra Kumar, Director, Drug De-addiction Programme, Ministry of Health acknowledged the success of the MMT project. He pledged support to the programme after the pilot phase, considering its possible inclusion under the ongoing flagship Drugs De-addiction Programme (DDAP), under the Ministry of Health & Family Welfare. He also highlighted the need for scaling up MMT, while involving state governments.
Shri Oscar Fernandes underlined the need to involve medical colleges as possible implementing partners and to make maintenance treatment programmes part of the study curriculum in medical colleges.
Mr. H Umesh Sharma, Coordinator, Indian Drug User Forum said that this initiative had been long awaited by the drug using community and that it should now be made available widely across the country.
MMT which started as an HIV prevention method, is now being seen as a larger public health measure, with governments recognizing its importance and efficacy. In India, MMT is currently supported by UNODC and NDDTC - AIIMS and available in the states of Punjab (Kapurthala, Bathinda), Manipur (Imphal), Maharashtra (Mumbai) and Delhi.
The pilot project is being implemented by UNODC with financial support from the UK Department for International Development( DFID), UNAIDS and GIZ, and in partnership with
- Civil Hospital, Kapurthala, Punjab
- Civil Hospital, Bathinda, Punjab
- Regional Institute of Medical Sciences, Imphal, Manipur
- KEM Hospital, Mumbai, Maharashtra
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi