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At some point you might feel that your drug use is getting out of control or that you want to make some changes but can’t do it on your own.

For most people, drug treatment reduces the risk of overdose and catching HIV or hepatitis and improves both health and relationships. It can also reduce risk of arrest and help you get things under control. Treatment choices for heroin and other opiate users include:

  • methadone and buprenorphine - safe and long-acting substitute medication that can help prevent withdrawals, reduce cravings and illicit drug use;

and for those who want to reduce their drug use, or become drug free there are:

  • residential detox and rehab programs;
     
  • home detox programs - both supervised (where you have someone checking on you
    by phone or visiting several times a day to offer support) and unsupervised;
     
  • therapeutic communities;
     
  • counselling and one-to-one support; and
     
  • self-help and support groups.

Remember: when it comes to drug treatment, different things suit different people at different times. Even if in the past treatment didn’t help you make the changes you wanted, it may be worth trying again.

In Queensland, for further information on drug treatment options contact the Alcohol and Drug Information Service on (07) 3236 2414 or regional freecall on 1800 177 833.

Below is the information the briefing paper gives to pharmacists to support the text on the calendar card.
It will hopefully be of interest both to professionals and injecting drug users.

Drug maintenance treatments are proven to help people reduce their drug use and minimise the health and social harms associated with drugs such as blood-borne virus transmission, overdose, and arrest.

Methadone and buprenorphine maintenance programmes are the best option for most opiate dependent individuals, but detox treatments can help the minority of drug users who want to stop their drug use entirely.

Maintenance treatments
Methadone is a synthetic opiate prescribed as a substitute for heroin, usually as part of treatment to stabilise dependence, although it can also be prescribed in reducing doses during a detox.

It doesn’t give the same hit as heroin, but it does give freedom from withdrawals.

Buprenorphine is another synthetic opiate. It is a partial opioid agonist, which means it is less intoxicating then methadone while still having maximum effect. For some this is a plus, for others it is a negative.

Although people who are in methadone or buprenorphine maintenance treatment are dependent on the drug, it has far fewer negatives than street heroin and enables users to lead a more stable life.

Many studies have shown that prescribed methadone or buprenorphine can help people who were dependent on heroin to:

  • stop using heroin (or greatly reduce the amount they take);
     
  • stop injecting (or inject less often);
     
  • improve their physical health and nutrition;
     
  • commit less crime; and
     
  • have more stable relationships and get on better with their families.

Detox options
For those who want to come off drugs or reduce drug use and have a reasonable chance of doing so, detox options include:

  • residential detoxification, rehabilitation programs and therapeutic communities;
     
  • home detoxification programs;
     
  • counselling and one-to-one support; and
     
  • self-help and support groups.

Unfortunately, becoming drug free is only an achievable short term goal for a minority of dependent drug users. Relapse rates from all forms of abstinence therapies are high.

Residential detoxification and rehabilitation programs usually involve a 3 - 6 week inpatient treatment phase, followed by extended outpatient therapy or participation in 12-step self-help groups like Narcotics Anonymous (NA).

For those with more social and psychological problems, therapeutic communities are highly structured programs where people stay at a residence, typically for 6 - 12 months.

Key intervention points:
Drug treatment works, and users considering drug treatment should be encouraged to speak with drug and alcohol workers and be fully informed about the options that are available.

It will help if you can explain the positive aspects of maintenance treatment to those dependent on opiates. Although they are not always popular with clients, for many they offer the best chance of reduced overdose risk, improved social functioning and reduced risk of catching hep C and HIV.

Further reading
Lintzeris, N. & Bath, N. (eds). (2001). Subutex: A guide to treatment. Melbourne: Turning Point.

National Drug and Alcohol Research Centre. (2000). What you need to know about Methadone... and other treatment options. Sydney: NDARC.

Preston, A. & Doverty, M. (1999). The Methadone Handbook (Second Edition). Melbourne: Australian Drug Foundation.

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