Indian Journal of PsychiatryIndian Journal of Psychiatry
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Year : 2018  |  Volume : 60  |  Issue : 3  |  Page : 361-366

Buprenorphine-based opioid substitution therapy in India: A few observations, thoughts, and opinions


1 Department of Psychiatry, Drug De-Addiction and Treatment Centre, PGIMER, Chandigarh, India
2 Department of Psychiatry, PGIMER, Chandigarh, India

Correspondence Address:
Dr. Abhishek Ghosh
Department of Psychiatry, Drug De-Addiction and Treatment Centre, PGIMER, Chandigarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/psychiatry.IndianJPsychiatry_218_17

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The most evidence-based treatment for opioid dependence is opioid agonist maintenance treatment also known as opioid substitution therapy (OST). However, there are some critical, yet unaddressed issues of buprenorphine-based substitution therapy, especially in the Indian context. These comprise of generalizability of the evidence for OST, especially for natural and pharmaceutical opioids and for all age groups, optimum dose and duration of OST, and mode of treatment delivery including the frequency of dispensing. Notwithstanding the use of buprenorphine-naloxone combination, abuse and diversion are serious but often underreported problems. There is an urgent need for health services research in India on OST, focusing on these aspects. Rather than directly copying from Western models, it is important to try to understand the useful and safe program and policy options likely to be applicable in the Indian setting, with our own assets as well as vulnerabilities.



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