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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