Opiate Substitution

Methadone

These substitute opiates will not produce a "high" and will allow the addict to regain control of their lives, and reintegrate effectively with society. Additionally, addicts using the "clean" opiates as prescribed in clinics minimize the health risks of their opiate usage, and increase their overall health.

The ultimate goal of opiate substitution therapy is to gradually reduce the dosage of the substitute opiate, until none is required. This is variably effective, and many addicts will remain dependent on the substitute opiate for years or even decades after initiating treatment.

There are some additional disadvantages to this method of treatment. Firstly, the addict remains physically dependent on an opiate, and requires regular opiate therapy to remain symptoms free. Methadone must be taken under supervision in a licensed methadone clinic (to avoid resale), and as such the continued time and energy commitment to the addiction remains significant. Additionally, many physicians are now arguing that methadone is in fact more addictive than heroin, and although addicts may function normally while on methadone, they have simply increased the level of their opiate addiction. The needed duration of methadone maintenance therapy reinforces this medical viewpoint, and raises serious questions about the appropriateness of this therapy.

Buprenorphine is somewhat better than methadone in the respect that it has no resale value, and can be prescribed in limited dosages for home consumption.

Ultimately, critics of the opiate maintenance therapy opine that these therapies do not offer the addict any behavioral skills for future drug avoidance. Without any counseling or therapy offered, there is little to keep addicts from a relapse to the pleasures, and ultimately pains, of heroin addiction.