The World Health Organisation recognises that opioid dependence is a complex health condition that requires long-term treatment and care. It is associated with a high risk of HIV infection when opioids are injected using contaminated injection equipment.
Drug dependence treatment is an important strategy to improve well-being and social functioning of people with opioid dependence and to reduce its health and social consequences, including HIV and hepatitis C infection.
As no single treatment is effective for all individuals with opioid dependence, sufficiently diverse treatment options should be available. Substitution maintenance therapy is one of the most effective treatment options for opioid dependence.
It can decrease the high cost of opioid dependence to individuals, their families and society at large by reducing heroin use, associated deaths, HIV risk behaviours and criminal activity.
Substitution maintenance therapy is a critical component of community-based approaches in the management of opioid dependence and the prevention of HIV infection among injecting drug users.
Provision of substitution maintenance therapy – guided by research evidence and supported by adequate evaluation, training and accreditation – should be considered as an important treatment option in communities with a high prevalence of opioid dependence, particularly those in which opioid injection places IDUs at risk of transmission of HIV and other bloodborne viruses.
In Australia two substitution drugs are available in pharmocaptherapy treatment – methadone and buprenorphine. While other countries have included herion in subsititution programs, Australia has not done so.