Theme: Models of Care Year: 2024
Background: In Nigeria, 90% of high-risk drug-users are opioid-dependent and 38% of injecting-drug-users in a recently concluded needle-syringe pilot-program, reported needle-sharing practices.There is a glaring risk of HIV-transmission and other blood-borne-diseases and a critical need to address the escalating public-health crisis associated with opioid-misuse and its dire consequences The 2020 IBBSS reveals a persistently high HIV-prevalence of 10.9% among people-who-inject-drugs (PWID), which significantly surpasses the 1.4% prevalence rate in the general population. In addressing opioid-use-disorder, Nigeria has developed programs/policies to support evidenced-based-interventions and implementation of comprehensive-package of harm-reduction-interventions, of which Medication-Assisted-Treatment (MAT) is one. Thus, this study seeks to explore the feasibility and potential impact of implementing MAT as a crucial harm reduction strategy to combat the opioid crisis in Nigeria and alleviate the associated health and societal burdens
Methods: The study took place in Abia, Gombe, and Oyo states of Nigeria. It used a mixed-methods-design that included 12 focus-group-discussions, 32 key-information-interviews and cross-sectional surveys involving 109 consenting PWIDs and stakeholders, such as law-enforcement-officers, drug treatment experts, community-based-service-providers, and policy makers. Data obtained were transcribed, re-translated, and analyzed using Atlas-ti-version-9 for content-analysis. Quantitative data-analysis was done using IBM-SPSS-Statistics for Windows, version-27 and the results were presented in simple frequencies.
Results: Drug-use was prevalent and associated with various criminal problems. The accessibility to care for individuals with substance-use-disorders is influenced by factors such as transportation, availability of treatment services, and presence of stigma in these communities. Notably, drug-users are often perceived as both individuals in need of assistance and as potential criminals. The legal and policy framework in Nigeria, was found to be adequate for the implementation of MAT. All drug users (100%) expressed acceptance, appropriateness, and feasibility of MAT as an intervention. However, several key challenges were identified, including issues related to funding, criminalization of drug-use, and the management of opioid-medication supply-chains. It was further revealed that drug-users favored a community-based approach for the implementation of MAT services. These findings underscore need for comprehensive approach that addresses these challenges and promotes a more supportive-environment for individuals seeking MAT services.
Conclusion: MAT is an acceptable and feasible treatment-option for individuals struggling with opioid-use-disorder. Addressing the barriers to implementing MAT may lead to improved overall functioning and quality of life of individuals with opioid-use-disorders.