OST can achieve similar outcomes consistently in a culturally diverse range of settings in low- and middle-income countries to those reported widely in high-income countries. It is associated with a substantial reduction in HIV exposure risk associated with IDU across nearly all the countries. Results support the expansion of opioid substitution treatment.

Background. The evaluation of quality of life and self-perceived health represents an assessment of the impact of treatment on patient functioning and well-being. Objective. Our aim was to explore the impact of methadone maintenance treatment on quality of life and self-perceived health of opioid-dependent persons in Lithuania. Methods. A total of 102 opioid-dependent patients were recruited in the study. A prospective follow-up study design was used. To assess quality of life, the WHOQOL-BREF 26-item version was used. The impact of methadone maintenance treatment on self-perceived health was assessed by Opiate Treatment Index (OTI). Results. Following 6 months of methadone maintenance treatment, significant improvements in physical (P=0.004), psychological (P=0.004), and environmental (P=0.048) components of quality of life were observed; no statistically significant improvements were found in social component of quality of life. Study participants reported lower rates of medical morbidity associated with injection (P<0.001), cardiorespiratory (P=0.034), musculoskeletal (P<0.001), neurological (P=0.013), gastrointestinal (P<0.001), and general health (P<0.001). Conclusions. Methadone maintenance treatment substantially reduces morbidity associated with opioid dependence and improves the quality of life of patients.

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Direct buprenorphine/naloxone induction was a safe and effective strategy for maintenance treatment of opioid dependence. Response to high-dose direct buprenorphine/naloxone induction appears to be similar to indirect buprenorphine-to-buprenorphine/naloxone induction and was not associated with reports of intravenous buprenorphine/naloxone misuse.

Background: Opiate substitution therapy (OST) in the Ukraine was not provided until 2004. As part of the introduction of OST, the first feasibility study was conducted in 2007. Six clinics in 6 cities were involved in providing OST and collecting data. Methods: A total of 151 opiate-dependent patients were given buprenorphine as a substitute, and a survey of substance use, HIV transmission risks, and legal and social status was conducted at baseline and at 6 and 12-month follow-up. Results: Illegal substance use and illegal activities and incomes were highly reduced, whereas employment rates and psychiatric problems improved. Retention was comparatively high (79.5%) after 12 months. No significant adverse events were reported. Conclusion: A successful implementation of OST in the Ukraine is feasible.