Historique
Rapport
Lowering the threshold: models of accessible methadone and buprenorphine treatment
Auteur(s) :
KEENEY, E. ;
SAUCIER, R.
Année
2010
Page(s) :
34 p.
Langue(s) :
Anglais
Éditeur(s) :
New York, NY : Open Society Institute
Refs biblio. :
88
Domaine :
Drogues illicites / Illicit drugs
Thésaurus géographique
HONG KONG
;
FRANCE
;
SLOVENIE
;
CROATIE
;
PAYS-BAS
;
CANADA
Thésaurus mots-clés
METHADONE
;
BUPRENORPHINE
;
PRODUIT DE SUBSTITUTION
;
SUBSTITUTION
;
TRAITEMENT DE MAINTENANCE
;
PROGRAMME
Note de contenu :
SOMMAIRE
Introduction
- Detoxification vs. Maintenance
- Low-threshold Programs
- Innovative Programs
Methadone on Demand: The Hong Kong Model
Treatment by Prescription in France
Slovenia: High Coverage, Low HIV Prevalence
Widespread and Uncontroversial: Methadone and Buprenorphine in Croatia
Methadone by Bus in Amsterdam
Vancouver: Integrated Low-threshold Models of Care
Introduction
- Detoxification vs. Maintenance
- Low-threshold Programs
- Innovative Programs
Methadone on Demand: The Hong Kong Model
Treatment by Prescription in France
Slovenia: High Coverage, Low HIV Prevalence
Widespread and Uncontroversial: Methadone and Buprenorphine in Croatia
Methadone by Bus in Amsterdam
Vancouver: Integrated Low-threshold Models of Care
Résumé :
From Canada to Croatia, countries throughout the world offer innovative models for methadone and buprenorphine provision. Accessibility is the cornerstone of methadone treatment in Hong Kong, where individuals can start treatment on demand, usually receiving their first dose the day they sign up at the clinic. In France, patients receive their methadone or buprenorphine through a prescription, as they would any other medication, which has the effect of destigmatizing medication-assisted treatment and mainstreaming the practice.
Early and comprehensive implementation of harm reduction services in Slovenia is credited with keeping HIV prevalence among injecting drug users below one percent. Slovenia also offers slow-release morphine as a third treatment option to those dependent on opiates. Croatia’s progressive model of medication provision, linked with comprehensive services and referrals, was established to be widespread and uncontroversial. In the Netherlands, the use of a bus to distribute methadone is part of the "methadone dispensing circuit" intended to reach a broad number of at-risk clients and to give clients incentives to progress through low, medium, and high-threshold medication provision. Vancouver, Canada’s model includes pharmacy dispensing and comprehensive "woman-centered, harm reduction-based" health and social support services for pregnant opiate users, including methadone provision.
Each of these programs offers new insights for how countries can make methadone and buprenorphine treatment accessable and oriented to meet the needs of people dependent on opiates, and in doing so, achieve progress in HIV and overdose prevention.
(Extract of the document)
Early and comprehensive implementation of harm reduction services in Slovenia is credited with keeping HIV prevalence among injecting drug users below one percent. Slovenia also offers slow-release morphine as a third treatment option to those dependent on opiates. Croatia’s progressive model of medication provision, linked with comprehensive services and referrals, was established to be widespread and uncontroversial. In the Netherlands, the use of a bus to distribute methadone is part of the "methadone dispensing circuit" intended to reach a broad number of at-risk clients and to give clients incentives to progress through low, medium, and high-threshold medication provision. Vancouver, Canada’s model includes pharmacy dispensing and comprehensive "woman-centered, harm reduction-based" health and social support services for pregnant opiate users, including methadone provision.
Each of these programs offers new insights for how countries can make methadone and buprenorphine treatment accessable and oriented to meet the needs of people dependent on opiates, and in doing so, achieve progress in HIV and overdose prevention.
(Extract of the document)