ISSUES OF ADHERENCE TO THE OPIOID SUBSTITUTION THERAPY IN THE NORTH OF MOROCCO


Author: Brahni T, Maguet O, Elkhammas M, Douraidi MA, Ouarsas L, Benmoussa A, Karkouri M, Himmich H

Theme: Models of Care Year: 2019

Background: Since 2013, when the opioid substitution therapy (OST) had been initiated in Tetouan,
a border town in the north of Morocco where people who inject drugs (PWID) is concentrated, no
study has been conducted so far on the issues of adherence to OST. This qualitative study assesses
and describes this issue in the light of an Islamic conservative society where stigma towards PWID is
very prominent.
Description of model of care/intervention: From 2013 to 2017, we selected 38 PWID under OST in
the medical and psychological center in Tetouan. Information was collected from interviews with the
field workers and database of the Harm Reduction project led by the Association de Lutte Contre le
Sida (ALCS).
Effectiveness: Among the 38 PWID selected, 26 were Male and 12 Female, the average of age was
41 years old and the OST duration was 2,2 years, 31/38 lived with family.
After the initiation of OST, 17/26 of the male PWID were polydrug users (4/12 of the female PWID),
7/26 dealt with their OST doses (2/12 of the female PWID), 9/26 continued injecting drugs (no
female PWID), 4/26 had been incarcerated (1/12 of the female PWID), 4/26 died of overdose (no
female PWID died).
Conclusion and next steps: Adherence to OST in the north of Morocco faces many issues, the social
and professional integration seems to be one the main cause. For this reason, ALCS has started a
project in the town to integrate them in order to contribute to the success of the OST.
Disclosure of Interest Statement: The project was conducted within Coalition Internationale Sida
network and funded by Unitaid.

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