WHO/Europe

Methadone substitution therapy

Kyrgyzstan’s Methadone Substitution Therapy Programme has proved effective in reducing illicit drug use, risk behaviour (needle and syringe sharing) and criminal activity. Further, substitution therapy has proven to improve self-rated health and social functioning, including increasing the employment rate.

The aims of substitution therapy are:

to assist people in remaining healthy until, with the appropriate care and support, they can achieve a drug-free life, or, if they cannot become drug free or want to quit the programme; drug dependence is a chronic disease, and treatment for years or even for their lifetime can be necessary;
to reduce the use of illicit or non-prescribed drugs;
to deal with problems related to drug misuse;
to reduce the dangers associated with drug misuse, particularly the risk of transmitting HIV, hepatitis B and C virus and other bloodborne infections from injecting and sharing injecting paraphernalia;
to reduce the duration of episodes of drug misuse;
to reduce the chances of future relapse to drug misuse;
to reduce the need for criminal activity to finance drug misuse;
to stabilize the person, where appropriate, on a substitute medication to alleviate withdrawal symptoms; and
to improve overall personal, social and family functioning.

The Methadone Substitution Therapy Programme has proved effective in:

reducing illicit drug use;
reducing risk behaviour (needle and syringe sharing) and criminal activity; and
improving self-rated health and social functioning, including increasing the employment rate.

Prison population

Studies have shown that substitution treatment in prison, if given in appropriate doses for the duration of the imprisonment:

reduces sharing of needle and syringes;
positively affects the prison by reducing drug-seeking behaviour;
makes reincarceration among prisoners receiving substitution therapy less likely;
has a positive influence on the contacts between staff and prisoners; and
reduces risk behaviour upon release.