Opiate treaments explained
Methadone is synthetic drug belonging to the opioid group. It is widely used to replace morphine or heroin in the treatment of drug dependence.
In this situation methadone is given once daily in liquid form to prevent symptoms of withdrawal in a person who has been smoking or injecting heroin. In some patients the dose of methadone can be reduced to the point where the drug is no longer needed; others require long-term treatment.
Its first widespread clinical use was in US Army veterans returning from Vietnam. Some soldiers had been injecting morphine while on service in South East Asia.
Because of the length of time that methadone stays active in the body it is ideal as a once a day drug. It works by locking on to opiate receptors in the brain so that even if a person was to inject heroin they do not experience the usual "buzz".
However it can be difficult to withdraw from completely. Methadone is currently the drug of choice in the Republic for the treatment of heroin addiction.
In France, the first choice treatment is a drug called buprenorphine, with methadone used as a back-up. Buprenorphine comes in tablet form and is dissolved under the tongue. Patients take it three times a week. It is accepted that buprenorphine is easier to completely withdraw from than methadone.
Now that we are seeing a different cohort of younger addicts who are smoking heroin, experts here agree that it may be time to consider using buprenorphine as first line treatment, at least in some patients.
In a study published this month in the journal Drug and Alcohol Dependence, a small number of addicts were given a "depot" formulation of buprenorphine. The injection contained tiny capsules that when injected slowly disintegrate in the body releasing small amounts of the drug over a period of weeks.
Researchers concluded that a single shot of the drug was effective and offered the prospect of making heroin treatment more flexible.
Other treatment options include a drug called lofexadine. It is a detoxification drug - in other words it is only suitable for short term use. Lofexadine is used in this country on a named patient basis only; it suits patients who have succeeded in reducing their methadone dose to 10 -15mls per day but are finding it difficult to finally come off methadone.