246810 Social Dimensions of Pharmaceutical Substitution Treatment

Tuesday, November 1, 2011

Grzegorz Wodowski , Outpatient clinic for drug addicts, MONAR Association, Krakow 31-063, Poland
Opiate substitution treatment in Poland is based on supervised distribution of methadone or high-dosage buprenorphine in state health care programs. Patients have to go on a daily basis to the clinic to get their medicine which can be a source of social problems and tensions. About 1800 people are treated in this way. Because of various reasons methadone cannot be prescribed. As an alternative to this type of maintenance treatment, physicians can prescribe low dosages of buprenorphine. The speaker runs one of the two out-patients clinics in Krakow which provide this treatment option, with about 40 patients participating in the program. The majority of them have experience with supervised methadone treatment. Although they perceived methadone as an effective substitution medicine, the distribution method was perceived as utmost problematic. The frequent visits to the clinic interrupted their daily life and the humiliating control measures decreased their self-esteem. The compulsory contacts with other drug addicts caused relapse. Since the social costs are too high, they prefer to be treated by less effective medicines (like low doses of buprenorphine). The treatment in our outpatient clinic gives addicts space to lead a normal life. Every two weeks the patients have psychiatrist's consultation and receive the next prescription. In addition they are obliged to take part in psychotherapy. Despite the fact that buprenorphine works only partly as an opiate agonist, it seems that for many addicts the social dimension of treatment is as important as the pharmaceutical effects of the treatment itself.

Learning Areas:
Planning of health education strategies, interventions, and programs
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
- To identify the difference between supervised distribution and prescription of opiate substitution medicines, - To define effective opiate substitution treatment satisfying the individual's needs, - To assess problems related to supervised substitution treatment programs with a large number of patients

Keywords: Methadone Maintenance, Treatment System

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a sociologist, social worker, certified therapeutist working with drug addicted people
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.