Publication:

Understanding the dynamics of opioid substitution therapy retention: a qualitative analysis of injecting drug users in Chandigarh

Background The World Health Organization (WHO) defines substance abuse as the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. Opioid substitution therapy (OST), which gradually and safely reduces an IDU’s opioid dependence. Several challenges at both structural and individual levels have arisen. Overcoming these hurdles is essential to fulfill the National AIDS Control Organization’s (NACO) mission to stop the spread of HIV. The present study aimed to identify the barriers to the OST program in Chandigarh and suggest strategies to overcome these challenges.

Methods A community-based cross-sectional study was conducted among injecting drug users (IDUs) at the four OST centers in Chandigarh. The study employed a concurrent mixed-method approach.

Results In this study, 81 respondents were surveyed, with 96.3% being male IDUs. The majority, 56.8%, were aged between 26 and 30 years, followed by 30.9% under 25 years. The most frequently injected drug was chitta (38.3%), followed by buprenorphine (9.9%), tapal (3.7%), and norphine (2.5%). With 66.7% of respondents indicated that time was an important and comfortable consideration to take OST. 65.4% of respondents indicated that the influence of OST influenced their decision to participate in the program. IDUs may leave OST follow-up if the dosage is inadequate to meet their needs. This can be a significant barrier to accessing OST.

Conclusions This study underscored the necessity of a holistic approach to address the barriers to OST utilization among IDUs in Chandigarh. A comprehensive approach involving education, stigma reduction, increased treatment accessibility, and community involvement is crucial for enhancing the effectiveness of OST programs.