Opioid replacement therapy (ORT) Harm reduction

number of yearly u.s. deaths involving prescription opioid pain relievers. non-methadone synthetics category dominated illicit fentanyl, , has been excluded more accurately reflect deaths prescription opioids.

opioid replacement therapy (ort), or opioid substitution therapy (ost), medical procedure of replacing illegal opioid, such heroin, longer acting less euphoric opioid; methadone or buprenorphine typically used , drug taken under medical supervision. formulations of buprenorphine incorporate opiate antagonist naloxone during production of pill form prevent people crushing tablets , injecting them, instead of using sublingual (under tongue) route of administration.

in countries, such switzerland, austria, , slovenia, patients may treated slow-release morphine when methadone deemed inappropriate due individual s circumstances. in germany, dihydrocodeine has been used off-label in ort many years, no longer prescribed purpose. extended-release dihydrocodeine again in current use in austria reason. research usefulness of piritramide, extended-release hydromorphone (including polymer implants lasting 90 days), dihydroetorphine , other drugs ort @ various stages in number of countries.

the driving principle behind ort program s capacity facilitate resumption of stability in user s life, while experience reduced symptoms of withdrawal symptoms , less intense drug cravings; however, strong euphoric effect not experienced result of treatment drug. in countries (not usa, uk, canada, or australia), regulations enforce limited time period people on ort programs conclude when stable economic , psychosocial situation achieved. (patients suffering hiv/aids or hepatitis c excluded requirement.) in practice, 40-65% of patients maintain complete abstinence opioids while receiving opioid replacement therapy, , 70-95% able reduce use significantly, while experiencing concurrent elimination or reduction in medical (improper diluents, non-sterile injecting equipment), psychosocial (mental health, relationships), , legal (arrest , imprisonment) issues can arise use of illicit opioids.