Harm Reduction Journal
Introduction: The emergence of widespread amphetamine-type stimulants (ATSs) usage has created signifcant
challenges for drug control and treatment policies in Southeast Asian countries. This study analyses the development
of drug policies and examines current treatment program constraints in Vietnam to deal with ATS misuse. The aim was
to gain insights that may be useful for national and international drug-related policy development and revision.
Methods: A desk review of national policy documents and 22 in-depth key informant interviews were conducted
from 2019 to 2021. Thematic content analysis was employed to identify key themes and their connections.
Results: Analysis identifed Vietnam’s 30-year history of developing policies and formulating strategies to reduce
supply, demand, and harm from illicit drugs. With the increasing number of people who use ATS (PWUA), Vietnam
has recently promoted harsh policy and law enforcement to deter drug use and supply. This policy trend prevails in
many Asian countries. The three main constraints in dealing with ATS misuse emerged from punitive and restrictive
drug policies. First, the general public believed that Centre-based compulsory treatment (CCT) is the only appropriate
treatment for all types of illicit drug addiction despite its low-quality service provision. The rigid drug policy has led
to social persuasion with impractical expectations for CCT efectiveness. Second, the emphasis on punishment and
detention has hampered new drug treatment service development in Vietnam. CCT has become monopolistic in the
context of impoverished services. Third, people who use drugs tend to hide their needs and avoid formal treatment
and support services, resulting in declined social coherence.
Conclusion: While new drugs are constantly evolving, the current law enforcement approach potentially constrains
expertise to adopt efective treatment services. This study suggests that the top-down policing mechanism presently
hinders the development of an appropriate intervention strategy for ATS misuse and diminishes social support to
service providers
Le Minh Giang, Nguyen Thu Trang, Nguyen Bich Diep, Dao Thi Dieu Thuy, Dinh Thanh Thuy, Han Dinh Hoe, Hoang Thi Hai Van, Thai Thanh Truc, Hoa H. Nguyen, Nguyen Ly Lai, Pham Thi Dan Linh, Vu Thi Tuong Vi, Cathy J. Reback, Arleen Leibowitz, Li Li, Chunqing Lin, Michael Li, Do Van Dung, Ste
Background: Methamphetamine use could jeopardize the current efforts to address opioid use disorder and HIV infection. Evidence-based behavioral interventions (EBI) are effective in reducing methamphetamine use. However, evidence on optimal combinations of EBI is limited. This protocol presents a type-1 effectiveness-implementation hybrid design to evaluate the effectiveness, cost-effectiveness of adaptive methamphetamine use interventions, and their implementation barriers in Vietnam. Method: Design: Participants will be first randomized into two frontline interventions for 12 weeks. They will then be placed or randomized to three adaptive strategies for another 12 weeks. An economic evaluation and an ethnographic evaluation will be conducted alongside the interventions. Participants: We will recruit 600 participants in 20 methadone clinics. Eligibility criteria: (1) age 16+; (2) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) scores ≥ 10 for methamphetamine use or confirmed methamphetamine use with urine drug screening; (3) willing to provide three pieces of contact information; and (4) having a cell phone. Outcomes: Outcomes are measured at 13, 26, and 49 weeks and throughout the interventions. Primary outcomes include the (1) increase in HIV viral suppression, (2) reduction in HIV risk behaviors, and (3) reduction in methamphetamine use. COVID-19 response: We developed a response plan for interruptions caused by COVID-19 lockdowns to ensure data quality and intervention fidelity
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