1 / 18

OPIOID SUBSTITUTION THERAPY

OPIOID SUBSTITUTION THERAPY. WHAT IS OST?. Harm Reduction has multiple tiers of service delivery Along with NSEP, Opioid Substitution Therapy (OST) is a well accepted strategy for HIV prevention, and forms the second tier of harm reduction

bainbridge-gourley
Download Presentation

OPIOID SUBSTITUTION THERAPY

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. OPIOID SUBSTITUTION THERAPY

  2. WHAT IS OST? • Harm Reduction has multiple tiers of service delivery • Along with NSEP, OpioidSubstitution Therapy (OST) is a well accepted strategy for HIV prevention, and forms the second tier of harm reduction • OST is substitution of the drug user’s primary drug of use with a medically safer drug • OST is substitution of primary route of use (injecting) with non-injecting route (Oral/ Sublingual)

  3. PHILOSOPHY OF OST

  4. INJECTING Vs OST

  5. WHY OST? IDU’S PERSPECTIVE

  6. CONTD.

  7. CONTD.

  8. OST UNDER NACP III • Is a medical intervention • Includes Buprenorphine and Methadone • Administers Buprenorphine in sublingual (under the tongue) form and in doses, which are not available in pharmacies • Is regulated under the Narcotic Drugs and Psychotropic Substances (NDPS) Act, it can be dispensed only in approved centres

  9. CRITERIA FOR OST Inclusion Criteria • Diagnosed case of opiod dependence with injecting drug • > 18 years of age • Attempted detoxification before • Willing to provide informed consent Exclusion Criteria • Severe medical illness • Established history of severe side effects to buprenorphine • Unable/incapable to provide informed consent • Concomitant use of other drug

  10. THE PROCESS… • Steps in administration: • Induction after history taking and physical examination by a doctor • Administration of medicines by nurse • Daily attendance at clinic for receiving medicine (Daily Observed Treatment - DOT) • Regular follow-up by doctor and nurse • Regular psychosocial therapy with counsellor

  11. OST ALSO REQUIRES… • Psychosocial intervention: • Information about treatment including dosage, duration, relapse, etc. • Referrals to ICTC, TB, ART, etc. • Motivational support • Counselling for employment, harm reduction, etc. • Family Support: Enhances retention of IDU to treatment & improves their chances of staying away from drugs

  12. TERMINATION OF TREATMENT • Treatment continues till the client: • is stabilised psychologically & socially • stops injecting (drugs) • starts working and being productive • Duration of treatment • usually 9 to 12 months; some may require longer time to stabilise

  13. OST ALONE IS NOT ENOUGH… • OST is a facility based programme and should be provided in addition to: • NSEP • BCC • General health care • Linkages/referrals • ART • DOTS • ICTC, etc.

  14. MYTHS ABOUT SUBSTITUTION TREATMENT

  15. MYTH #1: PATIENTS ARE STILL ADDICTED • FACT: Addiction is pathologic use of a substance and may or may not include physical dependence • Physical dependence on a medication for treatment of a medical problem does not mean the person is engaging in pathologic use and other behaviours

  16. MYTH #2: BUPRENORPHINE IS SIMPLY A SUBSTITUTE FOR ILLEGAL DRUGS • FACT: Buprenorphine is a replacement medication; it is not simply a substitute • Buprenorphine is a legally prescribed medication, not illegally obtained • Buprenorphine is a medication taken sublingually, a very safe route of administration • Buprenorphine allows the person to function normally

  17. MYTH #3: PROVIDING MEDICATION ALONE IS SUFFICIENT FOR OPIOID ADDICTION • FACT: Buprenorphine is an important treatment option. However, the complete treatment package must include other elements, as well • Combining pharmaco-therapy with counselling and other ancillary services increases the likelihood of success

  18. CONCLUSION OST: • Is cost effective • Is simple • Has minimal side effects • Has minimal chances of overdose • Requires family support and acceptance • Does not require extensive clinical set up • Acts best if provided supplementary to other services

More Related