Factors Affecting Addiction Severity Index (ASI) among Clients Enrolled in Methadone Maintenance Treatment (MMT) Program in Myanmar

Abstract Background: Opioid substitution with methadone maintenance treatment (MMT) is shown to reduce illicit opioid use and renew social-functioning. Understanding factors that undermine clients’ social-functioning during MMT treatment is vital for improving treatment compliance and quality of life. Method: A total of 210 respondents who were presently enrolled in 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 days. Higher ASI scores denotes poorer social-functioning. Result: Respondents total ASI scores in the respective domains were; employment (47.4%), alcohol (44.4%), drug use (7.2%), legal (49.2%) and social-family relationship (10.7%). Those reported to have never injected drugs in the last 30 days had lower ASI scores than those who reported injection drug use (p=0.026). After identifying the differences in ASI total scores, we found there are significant associations in the clients’ 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 days, income status, satisfaction with current marital status, as well as reported drug and alcohol use (p<0.05). Stepwise binary logistic regression showed alcohol and higher frequency of heroin injection is 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 (p<0.05). Conclusion: Our results indicate that those enrolled in 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 do not undermine their treatment compliance. Trial registration: NA