TY - JOUR
KW - Analgesics, Opioid/history/therapeutic use
KW - History, 20th Century
KW - History, 21st Century
KW - Humans
KW - Methadone/history/therapeutic use
KW - New Zealand
KW - Opiate Substitution Treatment/history/statistics & numerical data/trends
KW - Opioid-Related Disorders/drug therapy/history
KW - Practice Guidelines as Topic
AU - D. Deering
AU - J. D. Sellman
AU - S. Adamson
A1 - 
AB - We provide an overview of the history and philosophy of the treatment for opioid dependence, which has been dominated by methadone substitution treatment for the past 40 years in New Zealand. Although changes in approach have occurred over this time, influenced by various sociopolitical events and changing ideologies, opioid substitution treatment has still "not come of age". It remains undermined by stigma and risk concerns associated with methadone and has struggled to be accessible and attractive to illicit opioid drug users, comprehensive and integrated into mainstream health care. However, the introduction in 2012 of Pharmac-subsidised buprenorphine combined with naloxone (Suboxone) in the context of an emerging trend towards a broader recovery and well-being orientation could signal a new era in treatment. The availability of buprenorphine-naloxone may also facilitate a further shift in treatment from primarily siloed specialist addiction services to integrated primary care services. This shift will help reduce stigma, promote patient self-management and community integration and align opioid substitution treatment with treatment for other chronic health conditions such as diabetes and asthma.
BT - The New Zealand medical journal
C5 - Opioids & Substance Use; Healthcare Policy
CP - 1397
CY - New Zealand
IS - 1397
JF - The New Zealand medical journal
N2 - We provide an overview of the history and philosophy of the treatment for opioid dependence, which has been dominated by methadone substitution treatment for the past 40 years in New Zealand. Although changes in approach have occurred over this time, influenced by various sociopolitical events and changing ideologies, opioid substitution treatment has still "not come of age". It remains undermined by stigma and risk concerns associated with methadone and has struggled to be accessible and attractive to illicit opioid drug users, comprehensive and integrated into mainstream health care. However, the introduction in 2012 of Pharmac-subsidised buprenorphine combined with naloxone (Suboxone) in the context of an emerging trend towards a broader recovery and well-being orientation could signal a new era in treatment. The availability of buprenorphine-naloxone may also facilitate a further shift in treatment from primarily siloed specialist addiction services to integrated primary care services. This shift will help reduce stigma, promote patient self-management and community integration and align opioid substitution treatment with treatment for other chronic health conditions such as diabetes and asthma.
PP - New Zealand
PY - 2014
SN - 1175-8716; 0028-8446
SP - 57
EP - 66
EP - 
T1 - Opioid substitution treatment in New Zealand: A 40 year perspective
T2 - The New Zealand medical journal
TI - Opioid substitution treatment in New Zealand: A 40 year perspective
U1 - Opioids & Substance Use; Healthcare Policy
U2 - 24997702
VL - 127
VO - 1175-8716; 0028-8446
Y1 - 2014
ER -