Management of substance abuse

WHO collaborative research project on drug dependence treatment and HIV/AIDS

Drug injecting

Substitution therapy is a long-term approach used to reduce drug (usually opiate) use and the crime, death and disease associated with drug dependence. It seeks to cut down or eliminate drug use by stabilizing drug-dependent persons for as long as required to prevent them from relapsing into previous patterns of drug use and associated harms, including sharing of injection equipment. Substitution therapy is becoming more important due to: a) increased understanding of its role in HIV prevention and b) increasing importance for provision of HIV/AIDS treatment for injecting drug users (IDUs).

The WHO collaborative research project on drug dependence treatment and HIV/AIDS envisages three main inter-related components:

1. Evaluation of substitution treatment of opioid dependence in selected regions and countries

This component will include detailed descriptions of selected programmes and a research protocol to be implemented in 5 selected sites, that will include process and outcome evaluation of an existing programmes of opioid maintenance therapy, like methadone maintenance treatment. It will lead to the preparation of guidelines for the development and evaluation of opioid maintenance treatment programmes, including a training package.

2. Development of guidelines on integration of HIV-preventive interventions and evaluation of HIV/AIDS preventive capacity of drug treatment services

This component will focus on development of an essential package of HIV preventive interventions across various drug treatment programmes.

3. Development of principles of HIV/AIDS treatment and care in drug treatment services

This component envisages preparation of a comprehensive literature review, development and publication of an advocacy paper on HIV/AIDS treatment and care of drug-dependents, as well as the development of guiding principles for management of drug-dependent clients with HIV/AIDS, which will be piloted in the selected sites.

Future activities will be focused on increased coverage and quality of substitution treatment of drug dependence as HIV prevention and platform for HIV/AIDS treatment of IDUs as well as on improved treatment and care of drug-dependent people with HIV/AIDS.

Participating sites

China (Beijing); Indonesia (Denpasar, Jakarta); Islamic Republic of Iran (Teheran); Lithuania (Kaunas, Klaipeda, Vilnius); Poland (Warsaw); Thailand (Bangkok) and Ukraine (Kherson, Kiev).

Available documents