What is Opioid Substitution Treatment (OST)?
OST is a prescribed medicine – usually methadone or buprenorphine – used to replace the use of illicit opioids. It is administered orally and helps to reduce the craving for and abstain from illicit opioids, avoid the withdrawal syndrome and stabilise patient’s state and life. A psychiatrist will monitor your state and establish an optimal dose, which will allow you to feel neither ‘high’, nor depressed, your thinking will stay clear, coordination will not be affected. Adjusting the dose can take 1 to 3 weeks. OST is approved by Ministries of Health within the EU and is included in the World Health Organisation’s List of Essential Medicines. OST is also called Methadone Maintenance Treatment/Therapy (MMT).
How long does the treatment take?
Length of treatment varies from person to person. Usually it is 2 to 4 years, with one year considered to be the minimum length of treatment. You can terminate your OST at any point, however, if terminating prematurely, the patient risks to relapse to illicit opioid use.
What are the side effects?
Similar to any other medications, side effects are possible when taking methadone. Excessive sweating is most common among them. Slower metabolism and constipation can occur in the beginning of treatment. Most of the symptoms eventually disappear or can be eliminated adjusting the dosage, thus, you should always consult your doctor. OST usually improves patient’s health condition as it is seen by the increase of CD4 cells, the most important indicator of how well your immune system is working. This is especially important to monitor for people infected with HIV.
Is it harmful to my health, especially my liver?
Methadone is not harmful to your body but you should check for other bloodborne viruses, especially hepatitis C, which, if untreated, can do great damage to your health.
What is the difference between methadone and buprenorphine (Subutex, Suboxone)?
Both medicines are used in OST and the effect of the medications are highly similar. The choice of medication depends on your state and preference. Both medications are administered orally, however methadone is in liquid form, buprenorphine is a pill. Subutex is a brand name for buprenorphine, while Suboxone is a combination of buprenorphine and naloxone, with the latter preventing the use of tablets intravenously.
Can a pregnant woman take OST?
OST is highly recommended to pregnant women dependent on illicit opioids. On contrary to instability of illicit drug use and their fluctuating purity, which are highly harmful to the fetus and can cause miscarriage, low birth-weight and many other birth defects, methadone is safe both to the woman and the fetus, and allows safe breastfeeding (if the woman is not with HIV).
What is medication-assisted withdrawal?
People whose body is accustomed to prolonged use of illegal drugs, prescription medications or alcohol can experience withdrawal syptoms if they suddenly stop the use. This set of syptoms is called drug withdrawal syndrome and it may vary from mild to life‑threatening, thus medication-assisted withdrawal, when the severity of symptoms is alleviated, can be preffered by a patient or recommended by a physician.

Vilnius Centre for Addictive Disorders
Identification number 190999616
Gerosios Vilties Str. 3
LT-03147 Vilnius, Lithuania
Phone: +370 5 213 7274
Fax: +370 5 216 0019 banners banners banners