# Trust in addiction treatment services among people who use drugs in Vietnam

## TL;DR

This study explores factors affecting trust in addiction treatment services among drug users in Vietnam, highlighting the role of stigma and mental health.

## Contribution

The study provides new insights into trust in treatment services, distinct from provider-patient trust, in a transitioning healthcare context.

## Key findings

- Higher internalized stigma and depressive symptoms are linked to lower trust in addiction treatment services.
- Demographic factors and methadone maintenance treatment status do not significantly affect trust levels.
- Perceived care support is associated with trust in bivariate analysis but not after adjusting for other factors.

## Abstract

Although trust in addiction treatment providers and trust in treatment services are related yet distinct constructs, the latter remains underexplored. In Vietnam, where addiction treatment is transitioning from punitive models to community-based harm reduction, research on trust in treatment systems is particularly limited.

Baseline data were drawn from an ongoing randomized controlled trial conducted across three provinces in Vietnam, involving 690 people who use drugs (PWUD). Data were collected through face-to-face, computer-assisted interviews using validated and adapted measures in addiction treatment services, depressive symptoms, perceived care support, and internalized stigma related to methadone maintenance treatment (MMT). A linear mixed-effects regression model with commune-level random-effects was used to assess associations between trust in addiction treatment services and the measures of interest, including demographic characteristics.

Higher levels of internalized MMT stigma and depressive symptoms were both significantly associated with a decreased trust in addiction treatment services in the adjusted analysis. Demographic characteristics and current MMT status were not significantly associated with trust. Although trust in addition services was associated with perceived care support in bivariate analysis, this relationship was no longer significant after adjusting for other factors.

These findings suggest trust in addiction treatment could be understood not only as a function of provider-patient relationships but also in broader institutional and systemic contexts. Addressing treatment-related stigma and integrating mental health services in addiction services may be promising strategies to improve PWUD's trust in addiction services.