Reasons and characteristics of methamphetamine use among patients undergoing methadone maintenance treatment in Hanoi and Ho Chi Minh City: A qualitative study
Main Article Content
Abstract
Methamphetamine use among patients undergoing methadone maintenance treatment (MMT) is a growing concern due to its potential to compromise treatment outcomes and complicate the issue of opioid use disorder. This study examines the causes and characteristics of methamphetamine use among patients across 15 MMT clinics in Hanoi and Ho Chi Minh City. We conducted a qualitative approach, with data collected via 25 in-depth interviews and analyzed using thematic analysis. Findings indicate that methamphetamine initiation was primarily driven by curiosity, whereas continued use was sustained by the need for emotional regulation, enhanced alertness, work productivity, and sexual function. Notably, feeling bored with life and the high feeling from the drug rendered continuous abuse. Methamphetamine use patterns were not static but changed frequently, depending on the method of use, dose, frequency, financial situation, drug supply, drug purity, group or solitary use context, and post-use experiences.
Article Details
Keywords
Methamphetamine, methadone, qualitative study, opioid use disorder
References
1. Ellis MS, Kasper ZA, Cicero TJ. Twin epidemics: The surging rise of methamphetamine use in chronic opioid users. Drug Alcohol Depend. 2018; 193: 14-20. doi:10.1016/j.drugalcdep.2018.08.029.
2. Alam-mehrjerdi Z, Abdollahi M. The Persian methamphetamine use in methadone treatment in Iran: implication for prevention and treatment in an upper-middle income country. Daru. 2015; 23:51. doi:10.1186/s40199-015-0134-5.
3. Tsui JI, Whitney BM, Korthuis PT, et al. Methamphetamine Use and Utilization of Medications for Opioid Use Disorder among Rural People Who Use Drugs. Drug Alcohol Depend. 2023; 250: 110911. doi:10.1016/j.drugalcdep.2023.110911.
4. Russell C, Law J, Imtiaz S, Rehm J, Le Foll B, Ali F. The impact of methamphetamine use on medications for opioid use disorder (MOUD) treatment retention: a scoping review. Addict Sci Clin Pract. 2023; 18(1): 48. doi:10.1186/s13722-023-00402-0.
5. Hán Đình Hòe, Nguyễn Trường Giang, Nguyễn Thu Trang, Nguyễn Bích Diệp, Đỗ Đức Huy, Lê Minh Giang. Tình hình sử dụng methamphetamine trên bệnh nhân đang điều methadone tại Hà Nội và Thành phố Hồ Chí Minh. Tạp chí Y học dự phòng. 2024;34(2 Phụ bản): 137-145. doi:10.51403/0868-2836/2024/1648.
6. Nguyễn Bích Diệp, Nguyễn Thu Trang, Đỗ Đức Huy, và cộng sự. Non-adherence to treatment and concurrent opioid use among people on methadone maintenance treatment using methamphetamine in Vietnam. J Subst Use Addict Treat. 2025; 173:209686. doi:10.1016/j.josat.2025.209686.
7. Le Minh Giang, Li MJ, Okafor CN, Nguyen Bich Diep, Shoptaw SJ. Correlates of methamphetamine use severity among patients receiving methadone maintenance therapy for opioid use disorder in Vietnam. J Subst Abuse Treat. 2022; 132:108461. doi:10.1016/j.jsat.2021.108461.
8. Frost MC, Lampert H, Tsui JI, Iles-Shih MD, Williams EC. The impact of methamphetamine/amphetamine use on receipt and outcomes of medications for opioid use disorder: a systematic review. Addict Sci Clin Pract. 2021; 16(1): 62. doi:10.1186/s13722-021-00266-2.
9. Lê Minh Giang, Nguyễn Thu Trang, Nguyễn Bích Diệp, và cộng sự. An adaptive design to screen, treat, and retain people with opioid use disorders who use methamphetamine in methadone clinics (STAR-OM): study protocol of a clinical trial. Trials. 2022; 23:342. doi:10.1186/s13063-022-06278-w.
10. Le Minh Giang, Li MJ, Nguyen Thu Trang, et al. Interventions for methamphetamine use among people on methadone maintenance treatment in Vietnam: a sequential multiple assignment randomized trial (STAR-OM). The Lancet Regional Health - Southeast Asia. 2026; 48:100773. doi:10.1016/j.lansea.2026.100773.
11. Braun V, Clarke V. Thematic Analysis: A Practical Guide. SAGE; 2021.
12. Atlas.ti. ATLAS.ti: The Qualitative Data Analysis & Research Software. ATLAS.ti. 2024. Accessed June 7, 2021. https://atlasti.com/.
13. McNeil R, Puri N, Boyd J, Mayer S, Hayashi K, Small W. Understanding concurrent stimulant use among people on methadone: A qualitative study. Drug Alcohol Rev. 2020; 39(3): 209-215. doi:10.1111/dar.13049.
14. Wagner KD, Marks C, Fiuty P, Harding RW, Page K. A qualitative study of interest in and preferences for potential medications to treat methamphetamine use disorder. Addict Sci Clin Pract. 2023; 18(1): 47. doi:10.1186/s13722-023-00401-1.
15. Lopez AM, Dhatt Z, Howe M, et al. Co-Use of Methamphetamine and Opioids Among People in Treatment in Oregon: A Qualitative Examination of Interrelated Structural, Community, and Individual-Level Factors. Int J Drug Policy. 2021; 91:103098. doi:10.1016/j.drugpo.2020.103098.
16. Mackay L, Bach P, Milloy MJ, Cui Z, Kerr T, Hayashi K. The relationship between crystal methamphetamine use and methadone retention in a prospective cohort of people who use drugs. Drug Alcohol Depend. 2021; 225:108844. doi:10.1016/j.drugalcdep.2021.108844.
17. Frank D, Mateu-Gelabert P, Perlman DC, Walters SM, Curran L, Guarino H. “It’s like ‘liquid handcuffs”: The effects of take-home dosing policies on Methadone Maintenance Treatment (MMT) patients’ lives. Harm Reduct J. 2021; 18(1): 88. doi:10.1186/s12954-021-00535-y.
18. Fockele C, Morse S, Van Draanen J, et al. “That Line Just Kept Moving”: Motivations and Experiences of People Who Use Methamphetamine. West J Emerg Med. 2023; 24(2): 218-227. doi:10.5811/westjem.2022.12.58396.
19. Rhed BD, Harding RW, Marks C, et al. Patterns of and Rationale for the Co-use of Methamphetamine and Opioids: Findings From Qualitative Interviews in New Mexico and Nevada. Front Psychiatry. 2022; 13: 824940. doi:10.3389/fpsyt.2022.824940.
20. Cui Z, Hayashi K, Bach P, Milloy MJ, Kerr T. Crystal methamphetamine use and methadone maintenance treatment dissatisfaction: A prospective cohort study in Vancouver, Canada. J Subst Use Addict Treat. 2023; 151: 208956. doi:10.1016/j.josat.2023.208956.
21. Saloner B, Whitley P, Dawson E, Passik S, Gordon AJ, Stein BD. Polydrug use among patients on methadone medication treatment: Evidence from urine drug testing to inform patient safety. Addiction. 2023; 118(8): 1549-1556. doi:10.1111/add.16180.
22. Khalid K, Ooi YT, Abdul Rashid Q, Mohammad Yusoff MZA, Jamaluddin R. Methadone Maintenance Treatment for Opioid Dependents: a Retrospective Study. East Asian Arch Psychiatry. 2022; 32(3): 47-50. doi:10.12809/eaap2214.
2. Alam-mehrjerdi Z, Abdollahi M. The Persian methamphetamine use in methadone treatment in Iran: implication for prevention and treatment in an upper-middle income country. Daru. 2015; 23:51. doi:10.1186/s40199-015-0134-5.
3. Tsui JI, Whitney BM, Korthuis PT, et al. Methamphetamine Use and Utilization of Medications for Opioid Use Disorder among Rural People Who Use Drugs. Drug Alcohol Depend. 2023; 250: 110911. doi:10.1016/j.drugalcdep.2023.110911.
4. Russell C, Law J, Imtiaz S, Rehm J, Le Foll B, Ali F. The impact of methamphetamine use on medications for opioid use disorder (MOUD) treatment retention: a scoping review. Addict Sci Clin Pract. 2023; 18(1): 48. doi:10.1186/s13722-023-00402-0.
5. Hán Đình Hòe, Nguyễn Trường Giang, Nguyễn Thu Trang, Nguyễn Bích Diệp, Đỗ Đức Huy, Lê Minh Giang. Tình hình sử dụng methamphetamine trên bệnh nhân đang điều methadone tại Hà Nội và Thành phố Hồ Chí Minh. Tạp chí Y học dự phòng. 2024;34(2 Phụ bản): 137-145. doi:10.51403/0868-2836/2024/1648.
6. Nguyễn Bích Diệp, Nguyễn Thu Trang, Đỗ Đức Huy, và cộng sự. Non-adherence to treatment and concurrent opioid use among people on methadone maintenance treatment using methamphetamine in Vietnam. J Subst Use Addict Treat. 2025; 173:209686. doi:10.1016/j.josat.2025.209686.
7. Le Minh Giang, Li MJ, Okafor CN, Nguyen Bich Diep, Shoptaw SJ. Correlates of methamphetamine use severity among patients receiving methadone maintenance therapy for opioid use disorder in Vietnam. J Subst Abuse Treat. 2022; 132:108461. doi:10.1016/j.jsat.2021.108461.
8. Frost MC, Lampert H, Tsui JI, Iles-Shih MD, Williams EC. The impact of methamphetamine/amphetamine use on receipt and outcomes of medications for opioid use disorder: a systematic review. Addict Sci Clin Pract. 2021; 16(1): 62. doi:10.1186/s13722-021-00266-2.
9. Lê Minh Giang, Nguyễn Thu Trang, Nguyễn Bích Diệp, và cộng sự. An adaptive design to screen, treat, and retain people with opioid use disorders who use methamphetamine in methadone clinics (STAR-OM): study protocol of a clinical trial. Trials. 2022; 23:342. doi:10.1186/s13063-022-06278-w.
10. Le Minh Giang, Li MJ, Nguyen Thu Trang, et al. Interventions for methamphetamine use among people on methadone maintenance treatment in Vietnam: a sequential multiple assignment randomized trial (STAR-OM). The Lancet Regional Health - Southeast Asia. 2026; 48:100773. doi:10.1016/j.lansea.2026.100773.
11. Braun V, Clarke V. Thematic Analysis: A Practical Guide. SAGE; 2021.
12. Atlas.ti. ATLAS.ti: The Qualitative Data Analysis & Research Software. ATLAS.ti. 2024. Accessed June 7, 2021. https://atlasti.com/.
13. McNeil R, Puri N, Boyd J, Mayer S, Hayashi K, Small W. Understanding concurrent stimulant use among people on methadone: A qualitative study. Drug Alcohol Rev. 2020; 39(3): 209-215. doi:10.1111/dar.13049.
14. Wagner KD, Marks C, Fiuty P, Harding RW, Page K. A qualitative study of interest in and preferences for potential medications to treat methamphetamine use disorder. Addict Sci Clin Pract. 2023; 18(1): 47. doi:10.1186/s13722-023-00401-1.
15. Lopez AM, Dhatt Z, Howe M, et al. Co-Use of Methamphetamine and Opioids Among People in Treatment in Oregon: A Qualitative Examination of Interrelated Structural, Community, and Individual-Level Factors. Int J Drug Policy. 2021; 91:103098. doi:10.1016/j.drugpo.2020.103098.
16. Mackay L, Bach P, Milloy MJ, Cui Z, Kerr T, Hayashi K. The relationship between crystal methamphetamine use and methadone retention in a prospective cohort of people who use drugs. Drug Alcohol Depend. 2021; 225:108844. doi:10.1016/j.drugalcdep.2021.108844.
17. Frank D, Mateu-Gelabert P, Perlman DC, Walters SM, Curran L, Guarino H. “It’s like ‘liquid handcuffs”: The effects of take-home dosing policies on Methadone Maintenance Treatment (MMT) patients’ lives. Harm Reduct J. 2021; 18(1): 88. doi:10.1186/s12954-021-00535-y.
18. Fockele C, Morse S, Van Draanen J, et al. “That Line Just Kept Moving”: Motivations and Experiences of People Who Use Methamphetamine. West J Emerg Med. 2023; 24(2): 218-227. doi:10.5811/westjem.2022.12.58396.
19. Rhed BD, Harding RW, Marks C, et al. Patterns of and Rationale for the Co-use of Methamphetamine and Opioids: Findings From Qualitative Interviews in New Mexico and Nevada. Front Psychiatry. 2022; 13: 824940. doi:10.3389/fpsyt.2022.824940.
20. Cui Z, Hayashi K, Bach P, Milloy MJ, Kerr T. Crystal methamphetamine use and methadone maintenance treatment dissatisfaction: A prospective cohort study in Vancouver, Canada. J Subst Use Addict Treat. 2023; 151: 208956. doi:10.1016/j.josat.2023.208956.
21. Saloner B, Whitley P, Dawson E, Passik S, Gordon AJ, Stein BD. Polydrug use among patients on methadone medication treatment: Evidence from urine drug testing to inform patient safety. Addiction. 2023; 118(8): 1549-1556. doi:10.1111/add.16180.
22. Khalid K, Ooi YT, Abdul Rashid Q, Mohammad Yusoff MZA, Jamaluddin R. Methadone Maintenance Treatment for Opioid Dependents: a Retrospective Study. East Asian Arch Psychiatry. 2022; 32(3): 47-50. doi:10.12809/eaap2214.