Implementing opioid substitution in Lebanon: Inception and challenges.
Opioid Substitution Treatment (OST) is a firmly established method of treating and managing dependence to opioids in Europe, the US and rest of the developed world. It has a solid evidence base and a positive safety track record. Dissemination of its practice, in parallel to the acceptance of harm reduction as an effective approach, is still timid in low and middle Income countries. After years of advocacy on the parts of clinicians and the voluntary sector, the government of Lebanon launched a national opioid substitution program in 2011 using buprenorphine as the substance of substitution. Lebanon is one of the first countries in the MENA region to establish such a program despite a difficult socio-political context. This paper provides the background of harm reduction efforts in the region and presents the outline of the program from inception to present date. Challenges and recommendations for the future are also discussed. The Lebanese experience with opioid substitution is encouraging so far and can be used as a template for others in the region who might be contemplating broadening the range of services available to tackle addiction to heroin and related substances.
Department of Psychiatry, American University of Beirut Medical Centre, PO Box 11-0236, Riad El-Solh 11072020, Beirut, Lebanon.
Joseph
J
El-Khoury
Department of Narcotics, Ministry of Public Health, Mazraa - National Museum, (961) 1615745, Beirut, Lebanon.
Zeinab
Z
Abbas
Department of Psychiatry, American University of Beirut Medical Centre, PO Box 11-0236, Riad El-Solh 11072020, Beirut, Lebanon. Electronic address: pn09@aub.edu.lb.
Pascale E
PE
Nakhle
Department of Narcotics, Ministry of Public Health, Mazraa - National Museum, (961) 1615745, Beirut, Lebanon.
Marie-Therese
MT
Matar
D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D002047:Buprenorphine / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007861:Lebanon / Q000453:epidemiology; D058850:Opiate Substitution Treatment / Q000009:adverse effects; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D015397:Program Evaluation; D013997:Time Factors; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D002047:Buprenorphine
Addiction; Buprenorphine; Lebanon; Opioid; Substitution; Treatment