(

’
 barrriers to effective
decision-making

main problem
(treatment
challenges)

insufficient income inadequate

of the centers training

Approaches Consequences
Insufficient salary and fringe benefits for the personnel 1-Increased violations in the centers
1-closure of the centers 2-economic pressure on patients 2-Reduced number of active centers
3-reduced services 3-Withdrawal of patients from treatment
4-staff dissatisfaction and lack of motivation 4-Reduced service quality 5-Legal problems
1-reduced treatment quality 2-reduced number of patients under
1-increased motivation to return to drugs treatment 3-increased number of the patients dropping out of
2-patient’s return to the vicious cycle treatment 4-increased social issues 5-reduced competition
between centers 6-limited number of patients
1-difficulty in decision making in the case of some patients 1-lack of treatment for alcoholics
2-protocols that only apply to heroin and opium addicts 2-lack of treatment for the patients addicted to designer drugs
3-not including prevention measures in the protocols 3-not putting prevention benefits to use
4-the need for a psychiatrist for treatment 4-increased risk of heart problems caused by medication
5-non-mandatory QTC in the protocols 5-increased number of patients dropping out of treatment
6-insufficient privileges for the patients remaining on the
treatment
1-smoother processes 2-appropriate relationship between 1-increased treatment quality 2-patients remaining on treatment
personnel 3-personnel and patient satisfaction 3-providing standard services
4-quicker processes 5-providing better services 4-personnel retention
1-creating an incomplete process 2-lack of sympathy with
impatient personnel patients 3-inconsistency 4-withdrawal of patients from
treatment 5-inappropriate treatment services
Inadequate preventive measure in the centers increased risk of addiction for children and other family
members
1-inappropriate staff training during service 1-increased risk of error and danger
2-lack of attendance to the workshops 2-reduced service quality
3-failure to provide manuals for the patients
1-inefficiency of public policies 2-quantitative rather than 1-reduced service quality
qualitative monitoring 3-lack of expert supervisors 2-withdrawal of patients from treatment
4-out-of-date checklists 5-dissatisfaction of centers 3-drugs being released into the free market
6-patient dissatisfaction 7-increased violation
1-keeping patients away from injection 2-keeping patients
away from prostitution 3-keeping patients away from stealing help to reduce social/cultural/security problems
4-success in reducing AIDS 5-returning to the family
conflict and principle management

monitoring and control challenges

insufficient income of the centers

unfavorable economic conditions

inadequate insurance coverage

inefficiency of public policies

limitations of increasing the

the small role of prevention

weak management by the

benefits of MMT centers
personnel competency

motivational factors

insufficient training
number of centers

technical officer
unfair tariffs

teamwork

Contextual Condition Interventional Condition Casual Condition

Time