{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T03:26:33Z","timestamp":1776914793796,"version":"3.51.2"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T00:00:00Z","timestamp":1628121600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T00:00:00Z","timestamp":1628121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Harm Reduct J"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Opioid substitution with methadone maintenance treatment (MMT) is shown to reduce illicit opioid use and renew social functioning. Understanding factors that undermine clients\u2019 social functioning during MMT treatment is vital for improving treatment compliance and quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A total of 210 respondents who were already enrolled in a formal MMT program in Myanmar were recruited from five cities through stratified random sampling for this cross-sectional study. The addiction severity index (ASI) was used to objectively assess respondents social functioning in the last 30\u00a0days. Higher ASI scores denote poorer social functioning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      Respondents total ASI scores in the respective domains were: employment (47.4%), alcohol (44.4%), drug use (7.2%), legal (49.2%) and social\u2013family relationship (10.7%). Those reported to have never injected drugs in the last 30\u00a0days had lower ASI total scores than those who reported injection drug use (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). After identifying the differences in ASI total scores, we found there were significant associations in the clients\u2019 hepatitis C status, age category, frequency of heroin injection, quality of life score, marital status, current leisure status with family\/friend, current history of injection in the last 30\u00a0days, income status, satisfaction with current marital status, as well as reported drug and alcohol use (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Stepwise binary logistic regression showed that alcohol and higher frequency of heroin injection were associated with higher ASI scores. Meanwhile, older age, respondents those who had leisure time with family, and satisfied with current marital status had lower ASI scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results indicate that those enrolled in the MMT program in Myanmar faced many challenges in their daily social functioning. Treatment providers must take heed of these apparent impediment to ensure clients chequered social functioning does not undermine their treatment compliance.<\/jats:p>\n                    <jats:p>Trial registration: NA<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12954-021-00523-2","type":"journal-article","created":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T04:04:07Z","timestamp":1628136247000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Factors affecting addiction severity index (ASI) among clients enrolled in methadone maintenance treatment (MMT) program in Myanmar"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0973-4791","authenticated-orcid":false,"given":"Sun","family":"Tun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Vicknasingam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darshan","family":"Singh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,8,5]]},"reference":[{"key":"523_CR1","unstructured":"UNODC. \u201cWorld Drug Report.\u201d 15. UNODC, 2020."},{"key":"523_CR2","unstructured":"UNODC. \u201cWorld Drug Report.\u201d In: Global overview of drug demand and supply, Latest trends, cross-cutting issues, 12. UNODC, 2018."},{"key":"523_CR3","unstructured":"WHO. The methadone fix. WHO. 2008. https:\/\/www.who.int\/bulletin\/volumes\/86\/3\/08-010308\/en\/. Accessed 10 Sept 2020."},{"key":"523_CR4","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1080\/10550887.2012.694598","volume":"31","author":"G Bart","year":"2012","unstructured":"Bart G. Maintenance medication for opiate addiction: the foundation of recovery. J Addict Dis. 2012;31:207\u201325.","journal-title":"J Addict Dis"},{"key":"523_CR5","doi-asserted-by":"publisher","first-page":"e005997","DOI":"10.1136\/bmjopen-2014-005997","volume":"5","author":"H-M Sun","year":"2015","unstructured":"Sun H-M, et al. Methadone maintenance treatment programme reduces criminal activity and improves social well-being of drug users in China: a systematic review and meta-analysis. BMJ Open. 2015;5:e005997.","journal-title":"BMJ Open"},{"key":"523_CR6","unstructured":"Myanmar, The Global Fund Programme. In: The Global Fund Programme in Myanmar. 2020. https:\/\/pr-myanmar.org\/en\/disease\/hiv. Accessed 10 Sept 2020."},{"key":"523_CR7","unstructured":"Soe ZN (2013) Methadone program in Burma (Myanmar): challenges faced by methadone patients. NIDA International. 2013."},{"issue":"4","key":"523_CR8","doi-asserted-by":"publisher","first-page":"202","DOI":"10.5588\/pha.18.0050","volume":"8","author":"NS Aye","year":"2018","unstructured":"Aye NS, et al. HIV, HBV and HCV in people who inject drugs and are placed on methadone maintenance therapy, Yangon, Myanmar. Public Health Action. 2018;8(4):202\u201310.","journal-title":"Public Health Action"},{"issue":"9","key":"523_CR9","doi-asserted-by":"publisher","first-page":"1484","DOI":"10.1111\/j.1360-0443.2008.02249.x","volume":"103","author":"P Lawrinson","year":"2008","unstructured":"Lawrinson P, et al. Key findings from the WHO collaborative study on substitution therapy for opioid dependence and HIV\/AIDS. Addiction. 2008;103(9):1484\u201392.","journal-title":"Addiction"},{"key":"523_CR10","unstructured":"2019 HIV Reviews. MoHS Myanmar; 2019."},{"key":"523_CR11","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s12954-020-00413-z","volume":"17","author":"M Kermode","year":"2020","unstructured":"Kermode M, Choudhurimayum RS, Rajkumar LS, Haregu T, Armstrong G. Retention and outcomes for clients attending a methadone clinic in a resource-constrained setting: a mixed methods prospective cohort study in Imphal, Northeast India. Harm Reduct J. 2020;17:68.","journal-title":"Harm Reduct J"},{"issue":"3","key":"523_CR12","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/S0867-4361(14)70017-3","volume":"27","author":"M Nalaskowska","year":"2014","unstructured":"Nalaskowska M, Cierpia\u0142kowska L. Social and psychological functioning of opiate dependent patients in methadone maintenance treatment\u2014longitudinal research report. Alcohol Drug Addict. 2014;27(3):237\u201354.","journal-title":"Alcohol Drug Addict"},{"key":"523_CR13","unstructured":"T McLellan, J Cacciola, D Carise, and TH Coyne. \u201cAddiction Severity Index Lite - CF.\u201d 1999."},{"key":"523_CR14","unstructured":"McGahan PL, Griffith JA, Parente R, McLellan AT. Addiction severity index composite score manual. Philadelphia: The University of Pennsylvania\/Veterans Administration Center for Studies of Addiction, 1986."},{"key":"523_CR15","unstructured":"WHO. The World Health Organization Quality of Life (WHOQOL)-BREF. 2004."},{"key":"523_CR16","unstructured":"NIDA-CTN. Instrument: timeline followback method assessment. 2014. https:\/\/cde.drugabuse.gov\/sites\/nida_cde\/files\/TimeLineFollowBack_2014Mar24.pdf."},{"key":"523_CR17","unstructured":"Hangzhou Biotest Biotech Co., LTD. Hangzhou Biotest Biotech Co., LTD. 2018. http:\/\/en.biotests.com.cn\/."},{"key":"523_CR18","unstructured":"Research, Department of Medical. http:\/\/www.ercdmrlm.org. 2017. http:\/\/www.ercdmrlm.org\/pdf\/2017_Certificate_List.pdf."},{"key":"523_CR19","unstructured":"Tun S, Vicknasingam B, Singh DS. Factors affecting addiction severity index among methadone clients in Myanmar. In: 26th Harm Reduction International Conference (HR19) Porto, Portugal. Portugal: Harm Reduction International, 2019."},{"key":"523_CR20","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/j.drugalcdep.2013.10.011","volume":"134","author":"JP Feelemyer","year":"2014","unstructured":"Feelemyer JP, Des Jarlais DC, Arasteh K, Phillips BW, Hagan H. Changes in quality of life (WHOQOL-BREF) and addiction severity index (ASI) among participants in opioid substitution treatment (OST) in low and middle income countries: an international systematic review. Drug Alcohol Depend. 2014;134:251\u20138.","journal-title":"Drug Alcohol Depend"},{"key":"523_CR21","doi-asserted-by":"publisher","first-page":"e2","DOI":"10.1016\/j.drugalcdep.2014.02.043","volume":"140","author":"M Auriacombe","year":"2014","unstructured":"Auriacombe M, et al. 10-years outcome of methadone- and buprenorphine-maintained patients. Mortality, quality of life and substance use. Drug Alcohol Depend. 2014;140:e2\u201385.","journal-title":"Drug Alcohol Depend"},{"issue":"4","key":"523_CR22","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1016\/j.jsat.2011.05.003","volume":"41","author":"E Robles","year":"2011","unstructured":"Robles E, Huang BE, Simpson PM. Delay discounting, impulsiveness, and addiction severity in opioid-dependent patients. J Subst Abuse Treat. 2011;41(4):354\u201362.","journal-title":"J Subst Abuse Treat"},{"key":"523_CR23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1747-597X-9-1","volume":"9","author":"H Jiang","year":"2014","unstructured":"Jiang H, et al. Factors associated with one year retention to methadone maintenance treatment program among patients with heroin dependence in China. Subst Abuse Treat (BMC). 2014;9:1\u20136.","journal-title":"Subst Abuse Treat (BMC)"},{"issue":"4","key":"523_CR24","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1080\/10550880903183042","volume":"28","author":"A Fareed","year":"2009","unstructured":"Fareed A, et al. High dose versus moderate dose methadone maintenance: is there a better outcome? J Addict Dis. 2009;28(4):399\u2013405.","journal-title":"J Addict Dis"},{"key":"523_CR25","volume-title":"AIDS care","author":"C Roncero","year":"2017","unstructured":"Roncero C, Fuster D, Palma-\u00c1lvarez RF, Cintas LR, Martinez-Luna N, \u00c1lvarez FJ. AIDS care. Routledge: Taylor & Francis Group; 2017."},{"issue":"7","key":"523_CR26","doi-asserted-by":"publisher","first-page":"e69310","DOI":"10.1371\/journal.pone.0069310","volume":"8","author":"S-L Wu","year":"2013","unstructured":"Wu S-L, et al. Hepatitis C virus infection influences the S-methadone metabolite plasma concentration. PLoS One PLoS. 2013;8(7):e69310.","journal-title":"PLoS One PLoS"},{"key":"523_CR27","doi-asserted-by":"publisher","first-page":"e0123687","DOI":"10.1371\/journal.pone.0123687","volume":"10","author":"C-K Lin","year":"2015","unstructured":"Lin C-K, Hung C-C, Peng C-Y, Chao E, Lee TS-H. Factors associated with methadone treatment duration: a cox regression analysis. PLoS ONE. 2015;10:e0123687.","journal-title":"PLoS ONE"},{"issue":"1\u20132","key":"523_CR28","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/j.drugalcdep.2008.04.003","volume":"97","author":"UE Ghitza","year":"2008","unstructured":"Ghitza UE, Epstein DH, Preston KL. Self-report of illicit benzodiazepine use on the addiction severity index predicts treatment outcome. Drug Alcohol Depend. 2008;97(1\u20132):150\u20137.","journal-title":"Drug Alcohol Depend"},{"key":"523_CR29","doi-asserted-by":"publisher","first-page":"108466","DOI":"10.1016\/j.drugalcdep.2020.108466","volume":"219","author":"L Durand","year":"2021","unstructured":"Durand L, et al. Factors associated with early and later dropout from methadone maintenance treatment in specialist addiction clinics: a six-year cohort study using proportional hazards frailty models for recurrent treatment episodes. Drug Alcohol Depend. 2021;219:108466.","journal-title":"Drug Alcohol Depend"},{"issue":"4","key":"523_CR30","doi-asserted-by":"publisher","first-page":"241","DOI":"10.2471\/BLT.11.086850","volume":"89","author":"M Kermode","year":"2011","unstructured":"Kermode M, Crofts N, Suresh Kumar M, Dorabjee J. Opioid substitution therapy in resource-poor settings. Bull World Health Organ. 2011;89(4):241\u2013316.","journal-title":"Bull World Health Organ"}],"container-title":["Harm Reduction Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12954-021-00523-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12954-021-00523-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12954-021-00523-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T04:12:42Z","timestamp":1628136762000},"score":1,"resource":{"primary":{"URL":"https:\/\/harmreductionjournal.biomedcentral.com\/articles\/10.1186\/s12954-021-00523-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,5]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["523"],"URL":"https:\/\/doi.org\/10.1186\/s12954-021-00523-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-151916\/v1","asserted-by":"object"}]},"ISSN":["1477-7517"],"issn-type":[{"value":"1477-7517","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,5]]},"assertion":[{"value":"14 January 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This research approval was granted from the Human Ethics Committee of the Universiti Sains Malaysia (No:USM\/ JEPeM\/16080269) (University of Science, Malaysia) and Department of Medical Research (No: Ethics\/DMR\/2017\/057), Ministry of Health and Sports, [\n                      \n                      ].","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"All authors read and approved final manuscript submission. All authors agree to publish this prepared manuscript and no other submission of this manuscript to other journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare that there is no competing interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"84"}}