Stabilisation and maintenance

Heroin user interested in maintenance therapy treatment

What
Maintenance medications are meant to offer a break from cravings and withdrawal after each dose, giving you time to get your life back on track, minimise drug use and regain control. The hope is that this will provide a solid base for moving towards personal goals, including abstinence, when the time is right.

Maintenance treatment is usually provided by your doctor or pharmacist. Maintenance is a longer-term treatment, so building a relationship with your healthcare professionals is important.

Maintenance therapy is used to suppress cravings and minimise withdrawal after each dose which means it can help you become stable.

Who
People seeking to regain control of their lives, get healthier and take steps toward longer-term recovery and quality of life improvement.

Like
Life that revolves more around family, work, rehabilitation and Staying healthy, with cravings reduced by medication taken daily or even less often, depending on treatment choice, with the potential to take medication home once stable, again depending on the medication chosen.

Dislike
Depends on treatment chosen – see sections on buprenorphine, buprenorphine/naloxone, diamorphine and methadone. Some treatments have to be taken every day in front of the pharmacist or doctor.

How it works
Four maintenance therapies are available in the UK: buprenorphine, buprenorphine/naloxone, diamorphine and methadone. With the right dosing, these all affect the body like commonly used opioids, so the binding sites in the brain fill up, reducing cravings and withdrawals.

The difference is you shouldn’t expect to experience the same euphoric sensation you get with heroin. Maintenance treatments’ effects also last longer so they can be dosed at daily intervals, or even less frequently with some medications, putting you back in control so your life doesn’t need to revolve around the search for more drugs.

Importantly, because you are in treatment and reducing/stopping intravenous use, you are distancing yourself from some of the common health risks and dangers associated with drug use. Regardless of the maintenance medication used, patients on treatment are much less likely to die than those who remain out of treatment. They are also at much lower risk of infections like HIV and HCV or other injection-related problems like abscesses and collapsed veins.