Misconceptions dispelled

Explaining maintenance therapy used in the treatment of heroin users, Dr. Gihan Abeywardena says it is based on the principle that another longer-acting and less-addictive opioid should be used in place of heroin, to reduce the craving. This allows the altered brain of the heroin user to heal, paving the way for the person to get back to normal life and relationships.

The WHO-approved detoxification and maintenance therapeutic agents are Methadone and Buprenorphine. These have been used around the world in the past 50 years, it is learnt. A study published in the peerreviewed Journal of the American Medical Association (JAMA) in 2020 reveals that both these medications have been associated with a 32% relative rate of reduction in serious opioid-related acute care use at 3 months.

Dr. Abeywardena says that Sri Lanka turned away from these medicines for two reasons. One was the myth that the heroin used in the country is of low potency and the users do not get “real” withdrawal symptoms. The other was that Buprenorphine and Methadone can be diverted for street abuse.

Dispelling both these misconceptions, Dr. Abeywardena states that current studies show that the heroin used in Sri Lanka is of high potency. There is also a rapid spread of use including intravenous use which has become a critical issue for families and society.

The concern over Buprenorphine being diverted for street abuse can easily be overcome with its administration being strictly restricted to drug abuse treatment clinics in government hospitals, it is learnt.

“With Hepatitis C and also HIV numbers rising among intravenous drug users, heroin abuse has led to both medical complications as well as social issues,” adds Dr. Abeywardena.