Reasons for Discontinuation and Associated Factors in Opioid Agonist Treatment: A Community-Based Study from India

Retention in opioid agonist treatment (OAT) remains suboptimal. Few studies have directly explored reasons for OAT discontinuation among patients who leave treatment. This study examined reasons for OAT discontinuation, current substance use status after discontinuation, and associated clinical and psychosocial correlates.

Medical records of adult male patients registered for OAT during 2021 at a community-based clinic in New Delhi were reviewed in 2022. Reasons for treatment discontinuation were assessed using the Reason for Leaving Treatment Questionnaire through telephonic interviews with patients who discontinued OAT (n = 47) or their family members when direct contact was not possible (n = 23). Matched retained participants were also interviewed (n = 70). Motivation for change and perceived social support were assessed using SOCRATES-8D and MSPSS, respectively.

The most common reasons for discontinuation were perceived ability to maintain improvement without treatment (21.1%), occupational difficulty attending the clinic (14.5%), and relocation (13.2%). Nearly 60% of participants who discontinued OAT were abstinent from illicit opioids at interview. Compared with retained participants, those who discontinued reported higher current opioid use, poorer attitudes toward OAT medications, greater ambivalence toward change, and lower perceived social support.

Multiple structural and psychosocial barriers contribute to OAT discontinuation in community settings.