Methadone Maintenance Treatment Program in Prisons from the Perspective of Medical and non-Medical Prison Staff: A Qualitative Study in Iran

Background As one of the most important components of harm reduction strategy for high-risk groups, following the HIV epidemics, Methadone Maintenance Treatment (MMT) has been initiated in prisoners since ۲۰۰۳. In this paper, we aimed to assess the advantages and shortcomings of the MMT program from the perspective of people who were involved with the delivery of prison healthcare in Iran.   Methods On the basis of grounded theory and through conducting ۱۴ Focus Group Discussions (FGDs), ۷ FGDs among physicians, consultants, experts, and ۷ FGDs among directors and managers of prisons (n= ۱۴۰) have been performed. The respondents were asked about positive and negative elements of the MMT program in Iranian prisons.   Results This study included a total of ۴۸ themes, of which ۲۲ themes were related to advantages and the other ۲۶ were about shortcomings of MMT programs in the prisons. According to participants’ views “reduction of illegal drug use and high-risk injection”, “reduction of potentially high-risk behaviors” and “making positive attitudes” were the main advantages of MMT in prisons, while issues such as “inaccurate implementation”, “lack of skilled manpower” and “poor care after release from prison” were among the main shortcomings of MMT program.   Conclusions MMT program in Iran’s prisons has achieved remarkable success in the field of harm reduction, but to obtain much more significant results, its shortcomings and weaknesses must be also taken into account by policy-makers.

کلیدواژه ها:

Methadone Maintenance Treatment (MMT) ، Harm Reduction ، Prisoners ، Substance Use ، High-Risk ، Behaviors ، HIV