title: Perceived barriers to utilise methadone maintenance therapy among male injection drug users in rural areas of southern Thailand.
abstract: OBJECTIVE
  Methadone maintenance therapy (MMT) has been proven to be effective and cost-effective in treating dependence on opioids. However, concerns remain that geographical, financial and other hidden barriers may hinder access to MMT, especially in rural areas where health services are limited. The objective of this study was to determine factors associated with utilisation of MMT by injection drug users (IDUs) living in Songkhla province.
  
  
  METHODS
  A cross-sectional study among 159 IDUs in Songkhla province of southern Thailand was conducted. Participants were recruited using a snowball technique. Data were collected from July 2013 to January 2014 via face-to-face interviews.
  
  
  RESULTS
  Around one-forth (24.5%) of participants had difficulties travelling to MMT clinics because of the long distance, long travelling time and lack of a private vehicle. Twenty-four percent faced difficulties with the clinic's opening hours and 28% faced difficulties paying for the cost of travel. IDUs who utilised the MMT perceived risks of injection drug use differently compared with those who did not. Younger or Muslim IDUs were less likely to attend MMT. IDUs who perceived that MMT was effective were more likely to utilise MMT.
  
  
  CONCLUSIONS
  Physical accessibility, affordability and acceptability play an essential role in MMT utilisation. Developing alternatives that reduce the travelling time, costs for IDUs and more convenient operation hours to suit their lifestyles may increase the utilisation of MMT. Intensive consultation before starting MMT is highly recommended.
authors: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.|Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Nonthaburi, Thailand.
authors: Roongnapa
authors: R
authors: Khampang
authors: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors: Sawitri
authors: S
authors: Assanangkornchai
authors: Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Nonthaburi, Thailand.
authors: Yot
authors: Y
authors: Teerawattananon
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000379:methods / Q000706:statistics & numerical data; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D012424:Rural Population; D015819:Substance Abuse, Intravenous / Q000188:drug therapy*; D013785:Thailand / Q000453:epidemiology
chemical_list: D008691:Methadone
keywords: IDU; barrier; methadone maintenance therapy; utilisation