Opiate substitution medications: 3 reasons governments should legalize them

Governments that ban opiate substitution therapies often do not understand their uses and applications. Here we present three (3) reasons for the legalization of opiate substitution medications such as methadone and buprenorphine.

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Governments should consider legalizing opiate substitution therapy in order to:

1. Opiate substitution reduces the spread of HIV

Opiate addiction, especially injecting drug use (IDU), is associated with a very high direct risk of HIV infection. This is especially so in developing countries where HIV prevalence is high and opiate addiction among the youth is on the rise at a terrific rate. Many IDUs in this part of the world (Kenya) have no access to clean needles and syringes since needle exchange programs don’t exist or are not provided by governments. Furthermore, the cost of HIV treatment is much higher than that of providing opiate substitution therapy (OST). The morbidity and mortality assocplaces with HIV and AIDS places a very high financial and non-financial burden on governments that far outweighs the cost of legalizing and even providing OST.

2. Opiate treatment cuts down on the cost of health care

Treating opiate addictions such as heroin addiction is far more expensive due to its associated cor-morbidities (e.g. infectious diseases such as TB, Hepatitis, HIV etc and non communicable diseases such as hypertension, heart diseases, mental illness, physical ailments) than providing OST. Governments stand to make huge savings in both financial and non-financial resources. In developing countries where resources are scarce, the savings could be used to address other needs such as provision of education, healthcare and social amenities e.g. water, electricity, housing, employment opportunities, etc.

3. Opiate substitution therapy reduces crime and its costs

Opiate addiction is associated with high levels of both violent and non-violent crime as addicts try to get finances to procure drugs. It should be remembered that acute withdrawal effects (and not the ‘nice’ feeling(s) associated with opiates) are the main reason why addicts continue to use opiates. Many of the users will have lost their gainful employment as they engage in drug seeking and use activities; which means they will hardly have any money to buy drugs. The only avenue left to get the money is to still through violent and non-violent crime. This places a huge burden on governments in terms of the costs associated with ARREST and COURT processing, JAIL, PROBATION, FORGERY, ROBBERY and in some countries WELARE for these persons. OST being legal will prevent most of these activities and save governments colossal amounts of resources that could be deployed to other needy areas. Moreover addicts will be engaged in gainful activities such employment, education, community service etc.

About the author
Dr. Ndege is a former Hubert H. Humphrey scholar doing work in Kenya, East Africa on opiate substitution therapy and harm reduction measures, particularly among intravenous drug users, prisoners, and commercial sex workers. He lectures at Kenya Methodist University in the Department of Health Systems Management.


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  1. I just move from Atlanta to Nairobi and i was wondering if suboxone available in Kenya. Any information would be greatly appreciated. Thanks

  2. i , like adam j am also opiate dependant and have been for about 12 years .i’ve been on methadone for the last 3 or so years . i used to feel guilty about my addiction but not any more ..not since i realised that the drug i take makes it so much easier for me to get through life . i’ve been through some pretty harsh times .. especially in my younger years and maybe this is why i am the way i am ! personally i believe all drugs should be legalised .would’nt it be better to take this multi-billion euro industry away from organised crime and have it controlled by more responsible government agencies ! since starting on methadone i no longer have to deal with the criminal element to source my drug and this makes life so much easier .. it also means that i myself am no longer considered a criminal simply because of a substance i choose to take ! i have a university education and have worked all my adult life .I REALLY THINK IT’S TIME FOR CHANGE !!

  3. I have been an addict for 10 years and I have been on methodone for 2 years. What people don’t understand is that opiates are a treament for depression and anxiety. I have been through many things in my life and there are times when I am happy and don’t crave opiates that much and I can cope without them but there are also times when I am so depressed that doing heroin is the only thing that helps. Otherwise, I just feel like I would rather not live. Opiates help me to do the everyday things in life that I would not be able to do without them such as go to work, cope with everyday stresses. Why do we feel the need to suffer through life when there is something that can help up feel better. Most people look at heroin addicts as bad people when nothing could be further from the truth. Most of us just have a more difficult time dealing with life that others. I wish there was more I could do to help others see that using opiates is not a bad thing. I am all for legalizing opiates. By the way, I have a college degree and have always had a job and I’m a heroin addict. I know there are others out there like me and it sucks that all it could take is one time being caught that could ruin my life.

  4. started percocet in hospital for bone infection. was told that amount prescribed by doctor could not lead to addiction. wrong. after using the drug for the pain of six surgeries in 3 months, I didn’t know that I was addicted. I was told by the staff to make sure that I took what I was given so that I didn’t ” let the pain get ahead of me”. i hid and threw away about one third of the 10/325 percocets that they gave me and still I am addicted

  5. Making opiate substitution treatment available in places like Kenya is HUMAINE, in my opinion!

    I agree with Dudavinci in that I think that many people in the US stigmatize opiate substitution without really understanding the medical science behind it. For example, tapering occurs over a period of years, during which time addicts address their underlying issues. And most people think that addicts should “stop taking methadone” after a few months.

  6. I understand your point JT your comment is perfectly appropriate and very specific to the US market where the option for treatment and recovery have matured and known by the general and addicted population. But I can tell you for having witnessed it in most country around the world the drug treatment/detox/recovery industry or services is not very developed, and usually it always starts with opiate substitution program so the bridge between medical professional and the addicted population could be made possible. Also despite the fact that 12 steps program are supposedly present in most countries in the world there is a lack of information around the subject of treatment and recovery in general.

    Most addicts have completely isolated themselves, but if an opiate substitution program is existing and supported within their country of residence I can assure you that opiate addicts that really need it would take this option as a viable opportunity to get out of their miserable emotional, spiritual, social and often physical state. At least that’s my opinion.

  7. Opioid substitution for a short “detox” period is acceptable. However, our so called “Medical Professionals” are abusing the use of these drugs as much as the user. Subutex is being prescribed far too often. Patients are regularly discharged from a detox or treatment center with a new addiction. Arriving in a sober house only to withdraw yet again. One doctor I spoke with called it “The wave of the future”. God help us if this is true!!”

  8. I totally agree with you, it would cost less money to society to legalize and/or distribute opiate substitution medications to addicts. In my opinion getting opiate addicts within a legal framework could create a gateway between him/her and a society which could potentially lead to create an environment favorable to generate a dialog with people in need for social closure.

    I am just really asking myself what is the reason that stop most government from taking this option? I also do not understand why pharma lobbies have been so (far) inefficient at influencing the decision makers to implement this solution.

    Thanks for the article.

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