Therapy Helps Cure Opioid Addiction

Opioid addiction has become one of the world's most urgent public health concerns. In recent years, the abuse of opioids, including heroin, morphine, and prescription painkillers, has had serious negative social, economic, and health effects in recent decades. Methadone Maintenance Therapy (MMT) is one of the most successful methods for treating opioid dependence in which a medically supervised treatment that uses methadone, a long-acting synthetic opioid, to lessen cravings and withdrawal symptoms. Although the benefits of MMT are well-established and approved by the World Health Organisation (WHO), methadone therapy is still stigmatised and underutilised in many regions of the world. 

Methadone is a synthetic opioid agonist that binds to the same brain receptors as heroin and other opioids, but it does so gradually and under control. Methadone, with a unique pharmacological characteristic, counteracts the euphoric effects of other opioids and alleviates withdrawal symptoms, thus stabilising the patients both physically and psychologically. MMT is a part of a comprehensive treatment plan that typically includes counseling, social support, and access to health services. In this strategy, patients typically get daily doses at specialised de-addiction clinics or health centres under professional supervision to avoid abuse and guarantee adherence to the treatment plan.

Efficacy in harm reduction

MMT demonstrates efficacy in harm reduction. According to several studies, methadone dramatically lowers the danger of overdose, the spread of infectious diseases like HIV and hepatitis C, and criminal activity for drug seeking. There is frequently a significant decrease in risky sexual behaviours and needle-sharing in settings where MMT programmes are extensively accessible. This is particularly important in countries where injecting drug users have high prevalences of HIV. 

MMT improves public health by curbing the transmission of infectious diseases in addition to protecting individual users by limiting drug-seeking related behaviours. It also significantly enhances the quality of life for those struggling with addiction. People who are stabilised are more likely to pursue education or work, socialise, and get back in touch with their families. They can create long-term objectives and strive for a brighter future with fewer cravings and better mental health.

By reducing drug-related offenses, MMT also lessens the load on the legal system and law enforcement. To pay for their addiction, many opioid users take part in illicit activities. Methadone treatment reduces the desire to look for and use illegal narcotics, which eventually saves the government money by reducing arrests and court hearings. However, MMT is still stigmatised by the general public and certain medical experts. Methadone's opponents claim that it is just substituting one addiction for another. This perspective, however, ignores the essential distinction between medically supervised treatment and compulsive drug use.

Taking methadone as directed does not result in euphoria. Instead, it aids people in regaining control over their lives and achieving stability. Moral opposition to MMT is cruel since it denies individuals a practical route to recovery and is also scientifically incorrect.

Public education initiatives and healthcare practitioner training are crucial to altering the opposing mindset. Without bias or condemnation, we must embrace evidence-based therapies like MMT and treat addiction as a chronic medical illness rather than a moral failing. Research shows that every dollar spent on methadone therapy can result in many dollars in savings through lower expenses for the criminal justice system, fewer ER visits, and higher productivity at work.

The economic case for MMT is much stronger in low- and middle-income nations, where resources are frequently scarce and the health system is already overstretched. At a fraction of the cost of emergency treatment, governments may reach disadvantaged communities by incorporating MMT into their current public health systems. Furthermore, putting MMT programmes into place contributes to the development of more robust health systems. Other vital services like HIV testing, TB treatment, and mental health counseling are frequently offered by clinics that offer MMT. These integrated services provide a more comprehensive approach to care and improve health outcomes across several dimensions.

Opioid usage is still a major public health concern in Nepal, especially among underprivileged populations and urban youth. Despite initiatives to broaden harm reduction initiatives, such as methadone maintenance, coverage is still inadequate. Although Kathmandu and a few other regions have seen encouraging outcomes from the nation's Methadone Substitution Therapy (MST) program, the need for MST is significantly greater than the supply.

Inadequate funding

Inadequate funding, a shortage of trained staff, and cultural stigma still impede progress. Expanding MMT throughout Nepal, particularly in high-risk regions and among vulnerable groups, is both a strategic investment in the future of the country and a moral obligation. To improve current services, remove legal obstacles, and inform the public about the benefits of methadone therapy, policymakers, public health officials, and civil society organisations must collaborate. 

For those who are addicted to opioids, methadone maintenance therapy is a lifeline. MMT provides a pathway to recovery, stability, and reintegration rather than just a replacement. It is critical to give humane, evidence-based solutions like MMT priority as the worldwide opiate problem worsens. To guarantee that everyone in need of this essential treatment can get it, governments must make investments in increasing access, tackling stigma, and integrating services. The death penalty shouldn't be used for addiction. Recovery is not only feasible but likely with the correct support and methadone as part of a larger treatment plan.

(Dr. Lohani is the executive director at the Health Concern. lohanis@gmail.com)