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OST as a HIV prevention strategy among IDUs was formally integrated in National AIDS Control Programme (NACP) in 2007, during its third phase. Before formal integration, OST for HIV prevention among IDUs was being implemented in India by some NGO.
Janhvi Foundation statred OST center from April 2019 in Pimpri Pune
Various terminologies have been used to describe the clinical practice of maintaining opioid dependent drug users on opioid medicines over a long period of time. These include–oral substitution treatment, opioid substitution treatment, oral substitution–buprenorphine, medication assisted treatment, buprenorphine maintenance treatment, methadone maintenance treatment, etc. All these terminologies describe the same practice. Under the National AIDS Control Programme, the term ‘Opioid Substitution Therapy’ (OST) is currently in use.
OST is a process in which opioid-dependent injecting drug users are provided with long acting opioid agonist medications for a long period of time under medical supervision along with psycho-social interventions. Short term treatment of opioid dependence lasting for a couple of weeks called ‘detoxification’ which involves management of acute withdrawals alone, is associated with very high rates of relapse. Long term treatment is hence necessary for opioid dependence. OST is one such long-term treatment option.
The lives of IDUs revolve around illicit opioid use. Most of their day is spent in procuring the drugs, using them and/or recovering from the effects of the drugs. Withdrawals and craving associated with opioid use compel them to consume opioids repeatedly. As the opioid drugs usually have short-term effects, the drug using population needs to inject them multiple times throughout the day. As a result,they are not able to concentrate on other aspects of their life, including their work, family and social roles/responsibilities. They are also forced to indulge in illicit activities to finance their drug use. OST addresses a number of such issues faced by the IDU clients:
The benefits accrued from OST range from HIV prevention to treatment of opioid dependence, and from individual level to family and society level. The benefits of OST go beyond HIV prevention alone. A large body of literature is available globally that has documented the benefits and outcomes of OST. Substantial research has also been conducted in India on the use of OST in Indian settings. Evidence globally as well as locally shows that OST leads to improved retention and benefits detailed in the preceding section. OST has been endorsed and recommended as the most effective and first-line treatment option for long-term pharmacotherapy of opioid dependence. OST-RELATED OUTCOMES –
BENEFITS OF OPIOID SUBSTITUTION THERAPY