By WHO Regional Office for South-East Asia
The South-East Asia area is domestic to among 3.4 and 5.6 million injecting drug clients. a wide percentage of them inn to dangerous injecting practices akin to sharing of needles and syringes. This has resulted in the fast and large-scale transmission of HIV and hepatitis C during this inhabitants and their partners.In order to avoid new infections, nations have to urgently extend the implementation of evidence-based drug therapy interventions. Opioid substitution remedy (OST) is the main necessary and affordable intervention for dealing with opioid dependence and lowering the harms linked to it.OST is now to be had in India, Thailand, Indonesia and Nepal, and should quickly be brought within the Maldives and Bangladesh. those functional directions objective to help physicians and drug therapy pros in developing and supplying evidence-based, quality, potent OST providers in South-East Asia.
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Extra info for Operational Guidelines for the Management of Opioid Dependence in the South-East Asia Region
16,20,21 OST in closed settings is an important part of an opioid dependence treatment system to ensure continuity of treatment/care as many patients will spend time in jail due to the illicit nature of their activities. Despite this, OST is available in only limited sites across Asia. In general, methadone is preferable to buprenorphine for the treatment of opioid dependence in closed settings as it is more effective and less likely to be diverted. Detention in closed settings is often unexpected.
5 Vomited doses Vomiting of doses, if it occurs, is only relevant to methadone as buprenorphine is sublingually administered. Methadone is rapidly absorbed so vomiting more than 20 minutes after administration probably results in little loss of dose. Table 4. Management of vomited doses during opioid substitution therapy Time of vomiting Witnessed? 10 Alternative treatment 44 Many patients with opioid dependence will have other mental health and psychosocial issues which may beneﬁt from treatment during OST.
2 Psychosocial or pharmacological treatment (or both) 22 Psychosocial treatment is generally recommended as an adjuvant to all patients on pharmacotherapy. If a patient is to be given psychosocial treatment alone, it is important they have strong social support in place such as family or close friends. Given that many drug users are homeless and alienated from families and communities, this is frequently not easy to ensure. Psychosocial intervention alone may be undertaken when the patient does not wish to commence on medication or where the harm resulting from the use of pharmacotherapy is greater than the resultant beneﬁt.