A 40-year-old man dependent on heroin asks for help to stop. Which treatment is first-line in UK practice?
Answer and explanation
Correct answer: D. Opioid substitution therapy with methadone or buprenorphine
- Step 1: Substitution reduces harm, crime and mortality.
- Step 2: NICE recommends methadone or buprenorphine with psychosocial support, and naloxone supply.
Answer
Opioid substitution therapy with methadone or buprenorphine.
Why not the others: A course of antibiotics to treat the dependence: Antibiotics are not indicated. Long-term regular benzodiazepines prescribed in place of the heroin: Benzodiazepines are not treatment for opioid dependence. Abrupt cessation with no support or substitute medicine at home: Abrupt cessation with no support raises relapse and overdose risk.
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