Development of a methadone service model in the Drug Use Harm Reduction Center (Drop-in center) in Chiang Rai Province: Research and Development

Abstract

This Research and Development (R&D) study aimed (1) to examine the existing model of methadone services provided through harm reduction centers in Chiang Rai Province, and (2) to develop an improved service model that is appropriate for the local context. The research employed in-depth interviews, non-participatory observation, and data triangulation.

The study participants consisted of 10 staff members or network personnel from Drop-in centers and 30 individuals with opioid dependence who were receiving services at Drop-in centers in Chiang Rai Province. Data were collected using structured interview forms developed by the researchers. Descriptive statistics including percentages, means, and standard deviations were used for data analysis.

The findings revealed that the existing methadone service model in drug reduction centers in Chiang Rai Province emphasized the harm reduction concept, focusing on reaching drug users without the sole goal of abstinence, but rather for safer living and improved quality of life. The developed methadone service model thus focuses on flexibility to align with the context of service users and the work of Drop-in center staff networks within the local service areas. It promotes the integration and linkage of service systems into healthcare facilities to establish a One Stop Service. This integrated service includes Drug addiction treatment, screening for HIV, Hepatitis C, Hepatitis B, Sexually Transmitted Infections, and Tuberculosis. Furthermore, the model strengthens the connection between community hospitals and Drop-in centers by integrating treatment and rehabilitation to expand access to addiction services for drug users. The improved service system supports both onsite and digital service delivery through computer-based platforms and mobile applications, enabling timely coordination and data sharing across service units. This enhances overall efficiency, standardizes operations, improves network collaboration, and increases the convenience, speed, and responsiveness of services, thus building greater trust and confidence among service users.