Opioid substitution treatment in New Zealand: a 40 year perspective

N Z Med J. 2014 Jul 4;127(1397):57-66.

Abstract

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.

Publication types

  • Historical Article
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid / history
  • Analgesics, Opioid / therapeutic use
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Methadone / history
  • Methadone / therapeutic use
  • New Zealand
  • Opiate Substitution Treatment / history*
  • Opiate Substitution Treatment / statistics & numerical data
  • Opiate Substitution Treatment / trends
  • Opioid-Related Disorders / drug therapy
  • Opioid-Related Disorders / history*
  • Practice Guidelines as Topic

Substances

  • Analgesics, Opioid
  • Methadone