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 wellbeing 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. Opioid Replacement Therapy (ORT) is one of the most effective treatment options for opioid dependence.

ORT 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.

Replacement 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 ORT – 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 pharmacotherapy treatment; methadone and buprenorphine. While other countries have included heroin in substitution programs, Australia has not done so.

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