Descriptive Study on Addiction Rehabilitation Centers in Mashhad, With a Glimpse to Influential Factors for Discontinuing the Treatment by Patients

Maintenance treatments have been used extensively for opioid addicts in Iran. Generally all health related processes should be assessed and monitored for possible defects and to provide recommendations for improving the implementation of the executive-scientific process. In this regard, in this study the executive problems of methadone maintenance treatment (MMT) clinics in Mashhad were investigated. In this descriptive study, 35 out of 500 MMT clinics in Mashhad have been selected by easy random sampling. Interview with technical officers and supervisors of the clinics was done in winter 2014. Problems raised by the technical officers and supervisors were classified and analyzed. The problems posed by technical officers were classified to 5 general categories. Most important and frequent problems included supply of methadone in the illegal market (31.4%), change of type and quality of methadone (25.7%), lack of patients’ adherence to MMT (25.7%), lack of compliance to psychologic therapy (17.1%) and increasing number of clinics and maldistribution of them in the city (17.1%). In addition, supervisory authorities stressed on problems including absence of technical officers in some MMT centers and some clinics run by unqualified persons. The association between the presence of methadone in the illegal market, economic problems and lack of motivation with lack of compliance to and discontinuation of MMT was obvious in this study. Two problems including the presence of methadone in the illegal market and the need for rigorous supervision on MMT clinics with regards to remarkable increase in their number were raised by both technical and supervisory authorities.