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Patients and Methods Ethics Statement This study was approved by the Ethics in Research Committee at the Federal University of Gois under protocol number 195/11 dated 27 th June, 2011 and was conducted according to the Ethical Principles for Medical Research Involving Human Subjects of the World Medical Association Declaration of Helsinki

Barriers to effective treatment include the persistent stigma that Medication-Assisted Treatment (MAT) is simply trading one drug for another, despite its reducing harm

Some individuals report noticeable improvements within weeks, while others take longer

Program adherence: Some people find that a structured clinic visit supports routine and accountability, which can indirectly help lifestyle changes

But this hope does not reckon with the full extent of the challenge