WHAT IS OPIOID REPLACEMENT THERAPY?
Opioid replacement therapy (ORT) is the substitution of an opioid, such as heroin, with a longer-lasting prescription opioid with less potential for abuse. It’s also known as opioid substitution therapy (OST).
Methadone and buprenorphine are opioids that are typically used for this purpose and administered under the supervision of a healthcare provider.
ORT is a form of harm reduction. A harm reduction approach to drug use seeks to lessen the damaging effects of this behavior on the health and wellbeing of people who use drugs, as well as their communities.
WHO SHOULD CONSIDER ORT?
For people who use illicit opioids, ORT should be considered as a viable option for reducing the risk of overdose, getting HIV and HCV, and curbing addiction. It is best used by people who have an addiction and dependence upon opioids.
Using ORT eliminates the need for users to resort to illegal activity to prevent withdrawal. It also provides people who inject drugs (PWID) the opportunity to remove themselves from the illicit opioid market and community. This has been shown to be a large step in improving their quality of life.
Additionally, public health agencies should consider providing ORT or providing referrals to other organizations that do. These services can greatly improve the lives of their clients.
WHAT ARE THE BENEFITS OF ORT?
The largest benefit associated with ORTy is a reduction in the risk of fatal overdose. Other benefits include a decrease in risk of HIV and HCV transmission, injection-related bacterial infections, and illicit opioid use.
ORT also provides an opportunity for users to remove themselves from the illicit drug community without being forced to experience withdrawal, which has proven to be a significant barrier for a majority of individuals.
WHAT ARE THE CONCERNS ABOUT ORT?
Due to the fact that ORT follows a protocol created by a healthcare provider, some clients feel as though they have little control over their own treatment.
In addition, traveling to a clinical setting may be inconvenient for clients who are employed or rely heavily on public transportation.
Lastly, the effectiveness of ORT varies depending on the type of drug prescribed. For example, Suboxone, a combination of buprenorphine and naloxone, greatly restricts the possibility for abuse. However, when buprenorphine is taken by itself, the drug is more likely to be misused by a person taking it.
Despite these drawbacks, many clients find that the benefits of ORT are well worth the logistics of obtaining opioid replacement services.
THE BOTTOM LINE
Opioid replacement therapy (ORT) is an effective measure for reducing many of the harms associated with illicit, injection opioid use. When used efficiently, ORT can greatly improve the lives of opiate drug users.
National Harm Reduction Coalition: Medication for Opioid Use Disorder
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Reviewed March 2021Print PDF