Opioid Substitution Therapy - Establishing and Expanding Services
Presenter:Ms. Harsheth Kaur Virk, Project Officer- in- Charge, UNODC, ROSA
Co-Presenter: Dr. Jayadev Sarangi, Prison Expert, UNODC, ROSA
Ms. Harsheth Kaur Virk
Ms. Virk works as the Officer-in-charge for a regional project titled "Prevention of transmission of HIV among drug users in SAARC countries" for the United Nations Office on Drugs and Crime, based in New Delhi. As part of her job she has been working closely with governments and NGO counterparts across the SAARC countries to test scientific and locally developed toolkits in a variety of intervention settings. In addition she has also been involved in carrying out training programmes and researching the current situation on drug, HIV and related risk behaviours across the South Asian region.
Dr. Jayadev Sarangi is currently Prison Expert at UNODC ROSA. He is a serving civil servant of Government of India on secondment to UNODC. He has been associated with prison systems and management for nearly two decades. He holds a Ph.D. from the Indian Institute of Technology, New Delhi (thesis: "Factors Related to the Effectiveness of Correctional Organizations") and a Masters degree in Sociology from the Department of Sociology, Delhi School of Economics. Jayadev was the first UN Fellow on Prison Reforms in the year 1995 at the Crime Prevention and Criminal Justice Branch in UN Vienna.
Dr. Jayadev Sarangi
Issues
Need to enhance understanding of Opioid Substitution Buprenorphine (OSB)/ Methadone (OSM) as an effective and feasible intervention for prevention of HIV transmission among Injecting Drug Users (IDUs)
Need to establish mechanisms for scale-up for OS
Methods
UNODC ROSA has developed a set of six
Intervention Toolkits for comprehensive services (including OSB/OSM) that are available for use in the region.
a) UNODC ROSA supported a multi-site OSB study in India at 2 institutional and 3 community sites, which aimed to:
Outline the safety and effectiveness of buprenorphine
Describe the guidelines and procedures
Address quality assurance, other related issues and a rollout plan
b) UNODC ROSA is supporting an emergency response in Nepal, where OSM is being delivered through an institutional model with a social support unit for 100 clients over 12 months
c) UNODC in partnership with other stakeholders has advocated for initiating/scaling-up OS in the SAARC region
Results
Key findings at end of 9-month follow-up in India:
High retention rate, low current mean dosage
Significant reduction in drug use, injecting drug use, high risk injecting and high risk sexual behavior and an improvement in WHO Quality of Life and Addiction Severity Index Scores
As a result of advocacy, pilot interventions/scientific studies will be initiated/scaled-up (wherever appropriate) on OS in the region
Conclusion
OSB is feasible, effective, safe and acceptable
Combine with psychosocial intervention
Diversion preventable: Safe keeping possible
OST is an essential component of the comprehensive packages of services for prevention of HIV transmission among IDUs and hence, needs to be scaled-up in the region
Future Directions
Collaboration of stakeholders to develop methodologies on costings, procurement, capacity building, finalizing guidelines and policies on OS.
Ms. Harsheth Kaur Virk
Dr. Jayadev Sarangi
