In 2012 heroin was responsible for 30% of all drug deaths in Australia. People who are addicted to heroin are more than four times to die than the general population with the three commonest causes of death being polysubstance overdose, trauma and suicide. We know that people who use heroin or illicit opioids are 5 times more likely to die prematurely than the general population.
Opioid replacement therapy (ORT) is the replacement of a drug of dependence such as heroin with a legally prescribed opioid substitute with a stable and long half life such as Methadone or Suboxone which helps reduce cravings and the cycles of withdrawal. The use of Methadone and Suboxone in ORT is a form of harm reduction and it realises that for a number of reasons there are some people who are unable to remain abstinent of drugs and replacement therapy is a safer alternative.
Methadone maintenance therapy reduces heroin use, injecting behaviours and mortality and we know that by commencing ORT patients are:
more likely engage in healthcare
results in improved physical and psychological health
decreases criminal behaviour
increases social and community engagement
decreases harms associated with injecting drug behaviour
ORT has been present and used for a number of decades and has been extensively researched and has a good evidence base for it's effectiveness. It is something that is within the realm of all general practitioners and doctors and something that should be thought about and utilised more frequently than it currently is.
Author: Dr Thileepan Naren MBBS FACRRM FRACGP
Thileepan is an Addiction Medicine Advanced Trainee and experienced general practitioner with a demonstrated history of working with disadvantaged and marginalized groups.