India: Methadone Maintenance Treatment (MMT) now available

Methadone Maintenance Treatment (MMT) is now available for drug users, with the Civil Hospital in Kapurthala, Punjab being the first Methadone dispensing site. The MMT programme was launched on 3 February 2012 in Kapurthala as part of a pilot initiative undertaken by UNODC, in partnership with the National Drug Dependence Treatment Centre (NDDTC) of the All India Institute of Medical Sciences (AIIMS), New Delhi.

Drug dependence - commonly referred to as addiction, is a chronic relapsing condition similar to other non-communicable diseases like hypertension or diabetes, which requires long term treatment with medicines. Methadone is the most extensively used medication for long-term treatment for those dependent on opioid drugs. Extensive research in many countries in America, Australia, Europe and Asia (Iran, China, and Thailand), has shown that MMT significantly reduces drug use, HIV, Hepatitis-B & C transmission among drug users. It also gives them with an opportunity to restore balance in the psychological, social and occupational spheres of their lives and assists in their rehabilitation and reintegration into society. Worldwide, approximately 70 countries employ oral substitution therapy for opioid users, of which 48 use methadone treatment, servicing over 1 million individuals.

While 'Buprenorphine,' another long-term medication, is already available in India (including Punjab), under the National AIDS Control Programme, Methadone with its demonstrated effectiveness will add to the options available for treating opioid dependence. To this end, UNODC in partnership with NDDTC, AIIMS has initiated a MMT programme in India which will be implemented in five institutional sites across the country: (1) NDDTC, AIIMS, New Delhi, (2) KEM hospital, Mumbai, (3) Regional Institute of Medical Sciences, Imphal, (4) Civil Hospital, Bathinda and (5) Civil Hospital, Kapurthala. The programme will document the process of implementation of MMT, develop practice guidelines and an action-plan for up-scaling MMT in India.

During the inaugural event which took place in Kapurthala, Ms Cristina Albertin, UNODC Representative for South Asia delivered the welcome remarks along with presentations by UNODC and AIIMS explaining MMT. Mr Satish Chandra, Principal Secretary - Ministry of Health and Family Welfare, Punjab, the Chief Guest for the occasion gave an overview of the drug use problem in Punjab, the Government's efforts to address the same and emphasised on the need to support this initiative which could help many drug users give up drugs and lead better lives. In his key note address, Dr. Neeraj Dhingra, Deputy Director General, National AIDS Control Organisation (NACO)  stressed that injecting drug use needs to be approached in a holistic manner by different partners such as the medical fraternity, civil society, and other government departments, including law enforcement. Special Guest of Honour, Mr Sashikant, Director General of Police (Prisons) also pledged his support to the MMT initiative. Dr. Balbir Singh, Chief Medical Officer, Kapurthala, Mr Rohit Katiyar, Zonal director, Narcotics Control Bureau (NCB), India and Mr Paramjeet Singh, Deputy Commissioner, Kapurthala were also present during the launch.

Following a brief media interaction, MMT was formally launched by Mr. Sashikant and Dr Neeraj Dhingra, who dispensed the first doses of Methadone to the first two clients at the MMT Clinic in the Kapurthala Civil Hospital. The staff, including a doctor, a nurse and a research assistant, has been trained at NDDTC, AIIMS to implement the programme and monitor and document its progress. The initiative will be shortly rolled out in the remaining sites.

This initiative was implemented as part of the UNODC Project on 'Prevention of transmission of HIV among drug users in SAARC Countries' with funding support from AusAID, UNAIDS and GIZ

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