• 1. What is OST?

    OST substitutes illicit drugs with a medically safe, long acting agonist licit medication. It is prescribed by medical doctors and administered under the supervision of a trained nurse or pharmacist. Methadone and Buprenorphine are the most well studied medications used for Oral Substitution Treatment.

  • 2. Why do Opioid Substitution?

    The nature of drug dependence is such that it is a 'relapsing medical condition' and abstinence based approaches alone are unable to help the majority of drug users. OST results in significant harm minimization to the IDU, thereby reducing the risk of transmission of HIV and other blood borne viruses. For certain injecting drug users, abstinence can be achieved, if they are self-motivated to do so, by tapering of medication gradually through consultations between the doctor and the client.

  • 3. How OST works?

    It results in elimination of craving for the illicit drug. In addition, it blocks the effect of illicit opiate drugs if used by the drug user while he/she is on OST, thereby gradually leading to total abstinence and recovery.

  • 4. Is OST effective?

    Five Cochrane reviews on substitution treatment (Clark et al, 2003; Faggiano et al, 2003; Ferri et al, 2003; Mattick, Breen et al, 2003; Mattick, Kimber et al, 2003), which include 52 studies with a total of 12,075 participants have been conducted so far. These examined maintenance treatments on both buprenorphine and methadone, besides other maintenance medications. These have been carried out using rigourous research methodology in USA, Australia, Netherlands, Switzerland, Italy, UK, Austria, China, Thailand, Spain and Sweden.

  • 5. Is methadone maintenance treatment for me?

    If you’ve been using opioid drugs such as heroin, OxyContin, codeine, Dilaudid, Percocet and others, and you’ve come to a point where you know you can’t go on using, but you can’t seem to stop either, methadone maintenance treatment (MMT) may be right for you.

    You may be ready for MMT if you’ve been using for a year or more, and you’ve tried to stop. You’ve been through withdrawal, you’ve seen a counsellor, perhaps you’ve gone through a residential treatment program. If you can’t seem to stop using for more than a few hours, days, weeks or months at a time, and you know you want to stop, think about going on MMT.

    You’re ready for MMT when you’re still using and all it’s doing for you is keeping you “normal.” If there’s any high at all, it isn’t worth it anymore. You’re scared of being sick and all you want is to feel well and be free of the craving that nags you to keep on using. You want to be more in control of your life, your work, your home. You want to feel better about yourself; you want to be able to offer more to the people you care about

  • 6. Can I overdose on methadone?

    It is possible to overdose on methadone, but providers work to adjust dosages so that they are safe for each individual patient. It is important to be honest with the clinic staff about how much heroin or other opioids you are
    using so that they prescribe a dosage that is right for you—too little won’t be effective; too much could cause you to overdose. Methadone is a strong
    medication, so you need to build up the dosage slowly to be sure that your body is handling the medicine well.

  • 7. Can I overdose on buprenorphine?

    Misuse of buprenorphine is less likely than methadone to result in death.The risks of relapse following detoxification appear to be similar whether methadone or buprenorphine (or any drug-free treatment modality) is used

  • 8. What if I use other drugs while I am taking methadone?

    The correct dosage of methadone blocks the effects of heroin. If you take opioids while also taking methadone, you may not feel the effects of the opioids. You may then decide to take even more of the opioid, which could cause an overdose. Some drugs also interact with methadone and can change how your medications affect you (see pages 21–23). Taking too much of a sedative or drinking a lot of alcohol while you are taking methadone can also be dangerous because each substance makes the other more powerful, increasing your risk of overdose. Be extremely careful if you mix these drugs.

  • 9. Can I overdose on heroin while I am taking methadone?

    Yes. Even while taking methadone, if you take too much heroin—especially if the heroin is unusually strong—you could overdose. You increase the odds of overdosing on heroin while you’re taking methadone if you mix it with sedatives, alcohol, or other drugs.

  • 10. What if I stop going to my methadone program?

    If you stop taking your methadone and return to using street drugs, you can overdose more easily than when you last used. When you stop taking methadone, your body will rapidly develop a lower tolerance for the heroin. As soon as your methadone completely wears off (a couple of days), your tolerance for heroin will
    be lower than it was when you began taking methadone. So, if you decide to use again, you need to be very careful. Take some precautions—always be sure there are other people with you when you’re using, in case you need medical attention, and test the effect of the drug on you before you take an entire dose

  • 11. What happens if I start taking methadone again after I have stopped?

    If you stop taking methadone even for a few days, you need to be careful when you start taking it again. Your body may have lost some of its tolerance for the methadone, so you could overdose. You need to restart at a lower dose and work back up to the level you were at when you stopped. The doctor at the clinic can help you determine the right dosages.

  • 12. How long will I need to take methadone?

    The length of a methadone maintenance treatment program depends on a number of personal factors. Many patients remain in treatment for many months, and some continue to use methadone indefinitely (as with many chronic medical conditions).

    While methadone can safely be taken for months and even years, safe withdrawal from methadone is possible. As with any type of long-term medication regimen, ending methadone use must be done slowly, carefully and with supervision.

  • 13. Can Methadone Treat Addiction To Other Drugs Besides Heroin?

    When methadone is taken daily, as part of a long-term comprehensive recovery program, it has a high success rate in treating addiction to opioid drugs. This class of drugs includes those made from the opium poppy, like heroin, morphine, or opium itself – these are often called “opiates.” Other opioids are made synthetically, like the prescription drugs oxycodone (Percocet), hydromorphone (Dilaudid), hydrocodone (Vicodin), codeine, and others.

    Methadone is not used to treat addiction to non-opioid drugs, such as cocaine, alcohol, marijuana, or other substances of abuse. In fact, taking those other substances while in treatment can slow down a person’s progress in recovery

  • 14. What are the implications of OST for pregnant women?

    If you’re pregnant, and you’re using heroin, seek MMT right away. Methadone prevents opioid withdrawal, which can threaten the life of your baby.

    In many cultures, approximately one third of people with drug dependence are women of childbearing age, so the possibility of pregnancies needs to be taken into account and optional pregnancy tests made available. Pregnancies in this population should always be considered as high risk.  This makes their treatment a specialized field, requiring a multiprofessional approach, including prenatal care. Evidence-based standards of pharmacotherapy for opioid dependence treatment during pregnancy are available. Breast-feeding should be supported if desired by the woman if no contraindication is present. This specialized care is as an opportunity to interact early on a case management basis to reduce additional risk factors.

  • 15. What if the patient has HIV or Hepatitis C?

    Users who are HIV or hepatitis C positive are strongly urged to begin methadone treatment immediately. MMT helps to stabilize your health, and it lets you focus on getting the best possible care

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