Theme: Models of Care Year: 2025
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Background: In Nigeria, opioid-use is high with 4.6million users and out of the 376,000high-risk-drug-users, one out of five injects drugs. Nigeria’s-drug-problem is significantly-more-complex as a result of high-burden on its health-facility, high-drug-trafficking-activities, and limited-government-resources. In addressing opioid-use-disorder, programs/policies were developed to support evidenced-based-interventions/implementation of comprehensive-package of harm-reduction-interventions. Feasibility-study for medication-assisted-therapy/treatment (MAT) was conducted in 3states (AbiaGombe-Oyo) to evaluate the viability, acceptability, potential-barriers, appropriate-model for service-delivery and resources-required for its implementation as treatment to reduce opioid-addiction. A mini-pilot was conducted in 2022 among 10clients at Federal-Neuro-Psychiatric-Hospital-Maiduguri. Description of intervention: Site-assessment for the pilot was conducted in Gombe-State, health-care-workers (HCWs) trained on MAT-implementation. MAT-commodities (Methadone, Buprenorphine, Naloxone) arrived by December-2024 while facilities were renovated for effective-implementation. Frontline-HCWs were trained on mental-health & psychosocial-support, MAT-handlers trained to prevent narcotics-diversion. National-Harm-Reduction-Technical-Working-Group (NHRTWG) met to flag-off MAT-pilot. Law-enforcement-officers (LEOs) were trained for uninterrupted MAT-implementation. The pilot is for one-year with 900clients (80% methadone, 20% buprenorphine). Services are free from induction, dosing, maintenance and weaning-off stages. Demand-creation, social-mobilization and linkages are provided by PWIDs. Effectiveness: Two-health-facilities, one-OSS selected, assessed and renovated for MAT pilot in Gombe-State and 40general-HCWs trained for MAT-implementation. MAT-commodities (Methadone- Buprenorphine-Naloxone) are in country, 45Frontline-HCWs trained for mental-health and psychosocial-support provision, 53MAT-handlers trained to prevent narcotics diversion, 40LEOs trained for uninterrupted-MAT-implementation and NHRTWG flagged-off MAT-pilot. PWIDs created effective-demand for MAT-uptake. Conclusion and next-steps: With strong political-will and community-readiness for MAT-pilot and uninterrupted-implementation, the scale-up to 3 GF-states (Anambra-Ebonyi-Kwara) is certain. MAT-program will further-strengthen the-National-HIV/AIDS-framework to prioritize proven-measures to protect PWID/PWUD at-risk from infection. |