Opioid-related problems which includes addiction, are increasing and more doctors are likely to have connect with such patients. Addiction of a drug is a chronic disease, but opioid substitution treatment can reduce both death and disease. There is a considerable evidence base for the opioid substitution treatments for patient’s rehabilitation.The drugs which are used for the Opioid Substitution Treatment include methadone, naltrexone and buprenorphine which could be with or without naloxone. Regular assessments are required, not only to check for the efficacy and safety, but also to hold the patient in the treatment program. Below are the main drugs used for the treatment:
Methadone: Methadone in its oral inventionand has about 70% bioavailability equatedto the parenteral formulation. When ‘nil orally’ limits apply a 30% of usual dose drop is suggested. Patients on methadone who have severe pain will typicallyneed higher than customary doses of opioid analgesics because of tolerance while having their systematic daily methadone dose maintained.
Buprenorphine and naloxone: Buprenorphine is articulatedunaccompanied or in blend with naloxone. In the blend the buprenorphine to naloxone ratio remains 4:1, for instance16 mg buprenorphine with 4 mg naloxone. In addition to sublingual tablets, the blend is formulated as a film that melts rapidly under the tongue.
Naltrexone: Naltrexone has been used for opioid addiction as it simplifies the maintenance of opioid moderation. While naltrexone has effectiveness in treating alcohol dependence, the suggestion for naltrexone’s efficacy in curing opioid addiction is less impressive. Naltrexone is not suggested for simplifying rapid opioid detoxification.
Duration of the treatment:
Any king of addiction is a chronic disease so extended treatment for example more than a year can give the best outcomes, but many patients have tendency to discontinue opioid substitution therapy after moderately brief periods of improvement. Recalling a patient in therapy is hence an ongoing challenge for the doctor. Many opioid substitution programs recall patients for less than 12 months, treatment outcomes are improved when lengthier retention is attained.
Evaluating safety and efficacy:
Monitoring opioid substitution therapy is a vital part which must be taken good care. This includes regular valuation for any adverse events and the patient’s evolution. There are many long-term problems and other problems of opioid therapy including hypogonadism, gut motility disturbances, hyper algesia, osteoporosis, hyper hydrosis, tooth decay, sleep disorder and driving hazards. It must be ensured that safe storage and transport of the medicine is given to the patient. For example, Buprenorphine film may melt in temperatures which is above 25°C. anda lockable box to store take-away doses is crucial when children are at home.