Suchergebnisse

Opioids are one of the most common illicit substances used globally as well as in India. Opioid Agonist Maintenance Treatment (OAMT) is the most evidence-based long-term treatment for patients with opioid dependence syndrome. Buprenorphine is the most commonly used opioid medication for OAMT in India, while methadone and slow-release oral morphine are used less commonly. Buprenorphine was introduced in India around three decades back, and since then, many Indian studies have confirmed its effectiveness as OAMT in the Indian opioid-using population. The significant expansion of OAMT in India occurred when it became a part of the National AIDS Control Programme as an HIV prevention strategy. Since then, there has been a gradual expansion of OAMT under the National AIDS Control Programme. However, the provision of OAMT under this programme is limited to only people who inject drugs (PWID), thus leaving out the majority of opioid users in India. The Drug De-addiction Programme (currently renamed as National Program for Tobacco Control and Drug Addiction Treatment) under the Ministry of Health and Family Welfare (MoHFW) provides OAMT through its Drug Treatment Clinics (DTCs) in government hospitals across the country. The number of such DTCs is limited. More recently, the Ministry of Social Justice and Empowerment (MSJE) has approved a scheme of Addiction Treatment Facility (ATF) under which OAMT shall be available in Government hospitals at district level. The symposium will cover many of these issues and challenges. Presenter 1 will give a background of OAMT and will focus on its effectiveness in the Indian population. Presenter 2 will talk about the history and current status of OAMT under the National AIDS Control Organization. Presenter 3 will cover the history and current status of OAMT under MoHFW and MSJE. Presenter 4 will discuss the significant changes in the OAMT programs during the COVID-19 pandemic and the impact. Presenter 5 will discuss the major issues faced during the expansion of OAMT in India ...

India has a huge burden of substance use disorder (SUD). The national response to the problem of SUD has been to support addiction treatment centers either in government hospitals or in nongovernmental settings. The existing number of addiction treatment facilities is less compared to the burden of substance use in India. The existing models of treatment in India place undue emphasis on inpatient treatment of SUD. Community-based treatment aims to bring the treatment of SUD closer to the patients in their community. Community-based treatment of SUD utilizes existing services available in the community by establishing an integrated network of community-based services. There have been different models of community-based care for the management of SUD in India. Most of them, however, address short-term withdrawals and do not provide long-term treatment in community. National Drug Dependence Treatment Centre, AIIMS, New Delhi, has been providing community-based treatment for SUD since the 1990s. Two of the three community drug treatment clinics (CDTCs) are in operation for more than 5 years now and cater to the population residing within a defined catchment area. The CDTCs use infrastructure available in the community to operate the clinics. The clinics are run daily by a team of nursing staff, while the doctor is available only twice a week. A menu of options, ranging from short-term treatment to long-term agonist maintenance treatment is provided in the clinic. Both pharmacotherapy and psychosocial interventions are provided. Each clinic caters to hundreds of patients through these facilities. There is a need to expand CDTCs in India considering their cost-effectiveness, acceptability, and overall effectiveness, especially in urban colonies with higher substance-related problems.