Challenges to the pilot implementation of buprenorphine treatment for people with opioid use disorder in Vietnam 2019-2020

Objective: Between 2019 and 2020, buprenorphine treatment was piloted in Vietnam as a potential treatment option for opioid use disorder. This study aimed to describe the challenges encountered during the pilot implementation of buprenorphine treatment in Vietnam, which contributed to the decision not to expand the program nationwide. Methods: This qualitative study was conducted in Lai Chau, Dien Bien, and Son La provinces in January 2020. The study used in-depth interviews with a total of 40 partici-pants, including 18 methadone/buprenorphine program managers and providers, and 22 patients with experience receiving buprenorphine treatment. Results: Both patients and providers generally perceived buprenorphine to have positive clinical effects. However, four challenges were identified at the program level: 1) lim-ited accessibility to buprenorphine treatment, 2) heavy workload for providers without adequate compensation, 3) high pressure on providers to prevent buprenorphine diver-sion and 4) conflicts between the health system and police enforcement. Conclusions: Although buprenorphine treatment is well-established as an effective and cost-effective intervention for opioid use disorder, the existing programmatic organisa-tion of opioid use disorder treatment in Vietnam posed significant challenges. These challenges hindered both patients and providers from fully benefiting from the treatment. Keywords: Buprenorphine treatment, opioid use disorder, implementation challenges, qualitative study, methadone treatment, Vietnam