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❝ opiates may be illicit or prescribed ❞
Opiates are taken as 'street' heroin but also in a whole range of medications for pain relief - prescribed or taken illicitly.
Some frequently asked questions about treatment for opiate misuse...
#1 What can I expect from a methadone programme?
Benchmark :: National Treatment Outcome Research Study
This benchmark shows the outcomes from a large multi-centre study in UK drug treatment services. The study found heroin use was more than halved for people on methadone treatment in the UK. It did not make a huge difference whether treatment was in the community or residential. Use of alcohol and cocaine did not change significantly.
#2 Is just taking methadone all I need to do?
Benchmark :: intensity of psychosocial support
This research found that taking methadone alone was of little use. As a minimum some counselling or psychological help was important. Even better outcomes were achieved by adding employment advice, legal advice, and family therapy but not everybody needed these additions. The most cost effective combination is methadone with structured psychosocial support.
#3 What if methadone just doesn't stop me injecting heroin?
Benchmark :: substitute heroin prescribing
The RIOTT study found that, for injecting heroin users, where optimal methadone treatment had failed, then prescribed, supervised, injectable heroin was of benefit. There were improvements in terms of reducing illicit substance use. Whatever the substance use, supervision of injecting is safer than 'street' use. The charts show self reported and toxicology results for use of illicit heroin.
Opiate substitution is a common pharmacotherapy for opiate dependence...
Buprenorphine (Subutex™️ Suboxone™️) has less of an opiate effect than other substitutes but a much better safety profile.
Methadone has the longest history of use as a substitute. It is long acting and so withdrawal symptoms prolonged making it difficult to get off.
Diamorphine (heroin) is only prescribed in very particular circumstances. It is difficult to control diamorphine use just as it is with illicit heroin.