Medication for opioid use disorder in the Arab World: A systematic review

• Background: Opioid use disorder (OUD) is a global public health concern. The standard of care for OUD involves treatment using medications such as buprenorphine, methadone, or naltrexone. No known review exists to assess the contextual factors associated with medication for opioid use disorder (MOUD) in the Arab World. This systematic review serves as an implementation science study to address this research gap and improve the uptake of MOUD in the Arab World. Methods: Systematic searches of Medline, PsycINFO, and EMBASE, and a citation analysis, were used to identify peer-reviewed articles with original data on MOUD in the Arab World. Quality assessment was conducted using the CASP appraisal tools, and main findings were extracted and coded according to the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Results: 652 research articles were identified, and 10 met inclusion criteria for final review. Four studies considered health-systems aspects of MOUD administration, such as cost-effectiveness, the motivations for and impact of national MOUD policies, the types of social, political, and scientific advocacy that led to the adoption of MOUD in Arab countries, and the challenges limiting its wide-scale adoption in the Arab World. Six papers considered MOUD at individual and group patient levels by evaluating patient quality of life, addiction severity, patient satisfaction, and patient perspectives on opioid agonist therapy. Conclusion: Despite financial and geographic barriers that limit access to MOUD in the Arab World, this review found MOUD to be cost-effective and associated with positive health outcomes for OUD patients in the Arab World. MOUD can be successfully established and scaled to the national level in the Arab context, and strong coalitions of health practitioners can lobby to establish MOUD programs in Arab countries. Still, the relative novelty of MOUD in this context precludes an abundance of research to address its long-term delivery in the Arab World. © 2022

Ämnesord

SAMHÄLLSVETENSKAP  -- Annan samhällsvetenskap (hsv//swe)

SOCIAL SCIENCES  -- Other Social Sciences (hsv//eng)

SAMHÄLLSVETENSKAP  -- Juridik (hsv//swe)

SOCIAL SCIENCES  -- Law (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Nyckelord

Arab World

Implementation science

Medication for opioid use disorder

Opioid agonist therapy

Opioid use disorder

Substance use

buprenorphine

methadone

naloxone

opiate agonist

adoption

clinical evaluation

cost effectiveness analysis

disease severity

evidence based practice

human

opiate addiction

patient satisfaction

perception

policy

quality control

quality of life

Review

systematic review

Opioid use disorder; Substance use; Medication for opioid use disorder; Opioid agonist therapy; Implementation science; Arab World

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