Addressing unmet needs in opiate dependence: supporting detoxification and advances in relapse prevention

SUMMARY Despite record-breaking numbers of opiate related deaths in the UK 2019, pharmacological management dependence has evolved little since advent methadone 1965. Along with harm minimisation and psychosocial interventions, mainstay treatment remains opioid substitution therapy (OST) using or buprenorphine, many patients receiving OST for years. Even these treatments, users continue to face mortality risks 12 times higher than general population, emerging evidence suggests that individuals who remain on long-term present a range physical cognitive impairments. Therefore, growing ageing dependent population would benefit from detoxification OST, this article provides an overview current state clinical practice, explores reasons why availability acceptability pathways are declining, discusses therapies could provide relapse prevention.