Graduation Year

2023

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Dean's Office

Major Professor

Khary R. Rigg, Ph.D.

Co-Major Professor

Roger H. Peters, Ph.D.

Committee Member

Maayan Lawental, Ph.D.

Committee Member

Kristin Kosyluk, Ph.D.

Keywords

addiction, drug use, gender, prevalence, perception, enrollment

Abstract

Objectives. Vietnam has high rates of opioid addiction, but methadone maintenance treatment (MMT) only became available in Vietnam in 2008. To date, MMT has expanded nationwide serving about 51,000 patients. As MMT is relatively new in Vietnam, additional research on methadone patients is still needed. This dissertation aims to address two important issues related to MMT that have been understudied: the extent/type of substance use (SU) among MMT patients in Vietnam; and the low utilization of MMT among women.

Methods. This dissertation contains three separate, but related studies. Study 1 systematically reviewed 20 studies and summarized the literature on the types and extent of SU among Vietnamese MMT patients. Study 2 employed quantitative methods to identify gender differences in SU patterns, reasons for treatment entry, and attitudes toward MMT among 199 patients. Study 3 qualitatively described SU patterns, reasons for treatment entry, and attitudes toward MMT among 40 patients.

Results. SU was prevalent among Vietnamese MMT patients with a high rate of polydrug use. The most prevalent substances included heroin, tobacco, alcohol, and methamphetamine. Patients used heroin mostly to cope with withdrawal symptoms, boredom, and replace methadone on missing-dose days. Overall, gender differences were rarely found in terms of how patients used SU, reasons for entering treatment, and attitudes toward MMT.

Conclusion. SU is an active issue among MMT patients. Future research should further investigate SU patterns, and associated factors with decreased/increased SU while in MMT as well as further explore reasons for the low number of women in MMT. MMT providers should consider providing treatment for substances other than opioids. Findings suggest that patients might benefit from interventions such as case management, talk therapy, and emotional/social support. Additionally, employment enhancement such as vocational training and social networking programs should also be offered.

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