Historique
Périodique
Substitution therapy for heroin addiction
(Thérapie de substitution pour la dépendance à l'héroïne)
Auteur(s) :
BELL, J. ;
DRU, A. ;
FISCHER, B. ;
LEVIT S. ;
SARFRAZ M. A.
Année
2002
Page(s) :
1149-1178
Langue(s) :
Anglais
Refs biblio. :
75
Domaine :
Drogues illicites / Illicit drugs
Thésaurus géographique
AUSTRALIE
;
ROYAUME-UNI
;
CANADA
;
ISRAEL
;
FRANCE
Thésaurus mots-clés
HEROINE
;
PRISE EN CHARGE
;
TRAITEMENT DE MAINTENANCE
;
BUPRENORPHINE
;
SUBSTITUTION
;
HISTOIRE
Note générale :
Substance Use and Misuse, 2002, 37, (8/10), 1149-1178
Résumé :
Substitution treatment for heroin addiction, defined here as maintenance prescribing of opioid agonist drugs to opioid dependent subjects, has increased in the last decade. The recent history of substitution treatment in five countries- Canada, the U.K., Australia, Israel, and France is reviewed. In all five countries, the critical issues around substitution treatment are similar. The first key issue concerns the balance between making treatment accessible and attractive, and minimizing diversion to the black market. The second issue concerns the role of primary health care in delivering MMT. In general, there has been increasing involvement of primary health care, with training and support for practitioners. However, there remains uncertainty and official ambivalence over whether treatment should be restricted to specialist clinics and practitioners, or available through primary care. Most importantly, underlying these issues is the problem of stigma being associated with both addiction, and with substitution treatment. The underlying problem that treatment is often at odds with community values places enormous strains on substitution treatment, and makes the treatment system vulnerable to shifting community support and abrupt, politically-driven changes in policy. (Editor's abstract.)
Affiliation :
The Langton Ctr., Surry Hills, NSW 2010, Australia