Impact of Buprenorphine Opioid Substitution Therapy Programme in Nepal

Executive summary

Background

The major objective of this study was to assess the impact of buprenorphine opioid substitution therapy (OST) on the various aspects of life of opioid dependent people in Nepal.

Methods

The study was carried out in June and July 2014 in four OST centers in Kathmandu Valley, Nepal. The study population consisted of people who use drugs aged 18 years and above who were currently using OST provided by Youth Vision. Mixed research approaches were employed. The qualitative research approach included semi-structured interviews with six organisational key informants and the quantitative research was based on individual interviews with 220 opioid dependent persons (88% male, 12% female). Among the interviewees there were variations in socio-demographic characteristics, the age of entering the drug use habit, the types of substances used, the length of drug use, risk behaviour, treatment, knowledge about HIV and AIDS, and time of using OST with buprenorphine.

Results

OST with buprenorphine has created significant changes in the different aspects of life of the people who use drugs, at individual level, family level, at work, in education, and so on. Almost all respondents reported improvement in personal hygiene. Other changes included money saving, good relationship with family members, adoption of safe sex practice, not using drugs, regular in work, assisting friends to avoid drugs, and being healthy. Some respondents suggested that the police needs a specific awareness programme on how to treat drug users.

Conclusions

OST with buprenorphine has brought positive changes in the lives of people who use drugs and has improved their health and family life situation in general. They have become optimistic about their lives and wish to become a ‘normal’ person in future. However, they find they are treated wrongly by the police and demand to be treated as people with a disease and not as criminals. The coverage and access of the programme was recommended to be increased.