Maintenance or long term stabilisation are strategies to manage opioid dependence and achieve clinical stability during the recovery process. It is achieved by substituting the opioid on which the patient has been dependent with medication, usually buprenorphine or methadone, prescribed by a specialist doctor. This strategy is called Opioid Substitution Therapy (OST) and has many benefits:
• Patients move away from the illicit market and illicit activities.
• Reduced risk of overdose. You never know for sure the type of opioid you are taking (heroin, fentanyl, other), the dose and the substances it has been mixed with.
• OST involves treatment with licensed medications prescribed by registered professionals that will strongly support your mental, physical and social recovery.
• OST will also reduce the risk of infections associated with the use of paraphernalia, and illicit manufacturing of taken drugs.
At The OAD Clinic we offer OST with Buvidal (buprenorphine subcutaneous injection), buprenorphine tablets and methadone mixture.
The process starts with a comprehensive clinical assessment, history and nature of drug use, risk assessment, mental health assessment, physical examination and drug testing. Occasionally we may request some blood tests or other investigations.
There are two medications licensed for OST in the UK. These are buprenorphine and methadone. Buprenorphine is usually prescribed as sublingual tablets and methadone as a liquid formulation.
Whilst on oral buprenorphine or methadone, you need to undergo a titration (dose adjustment) period until you reach your optimal dose. This usually takes a few days with buprenorphine and a bit longer with methadone. It will also require an initial period of supervised doses and more frequent pick ups from the pharmacy.
We can also offer our patients a monthly buprenorphine subcutaneous (under the skin) injection (Buvidal).
This is a perfect option for those who do not want to collect medication from the pharmacy every week, keep it at home or travel with it.
