Drug Replacement and Maintenance Therapy

Drug replacement and maintenance therapy have a long history of providing individuals struggling with problematic drug use with legal access to drugs that would otherwise be obtained through illegal means.
The Centers for Disease Control and Prevention, the Institute of Medicine, the Substance Abuse and Mental Health Service Administration (SAMHSA), the National Institute on Drug Abuse (NIDA), the World Health Organization and over four decades of government-funded, peer-reviewed medical research have unequivocally and repeatedly proven that replacement therapies like methadone maintenance are the most effective treatments for opioid dependence.

Methadone and Buprenorphine

Methadone is the most widely-used maintenance treatment. Used properly, methadone reduces drug use and related crime, death, and disease among heroin users. But methadone has been handicapped by restrictive government regulations, by misinformation - among treatment providers and drug users alike - and by prejudice against methadone treatment.
Methadone is the most tightly restricted drug in the U.S. Doctors in general medical practice can't prescribe methadone, and regular pharmacies don't distribute it.
Buprenorphine is a newer medication that has also been shown to be effective and it can be prescribed by physicians who have gone through special training.
The Drug Policy Alliance advocates for making both methadone and buprenorphine more accessible, through changing attitudes, laws, regulations, and health insurance policies. Funding must be increased for access to methadone and buprenorphine through the public health system for those who cannot afford it otherwise.

Heroin-Assisted Treatment (HAT)

For drug users who have not found success with methadone, the most dramatic developments in drug substitution therapies have been in the field of Heroin-Assisted Treatment (HAT). HAT programs, as part of comprehensive treatment strategies, provide substantial benefits to long-term heroin users who have not been responsive to other treatment.
Studies have shown that those enrolled in HAT demonstrate a reduction in drug use and an improvement in overall physical and mental health. Additionally, several studies have found that individuals who participated in these programs significantly reduced their involvement in criminal activities, generating large cost savings.
Heroin maintenance may be a feasible, effective and cost-effective strategy for reducing drug use and drug-related harm among long-term heroin users for whom other treatment programs have failed.

Extended Release Naltrexone (Vivitrol®)

November 30, 2016
The U.S. Food and Drug Administration (FDA) has approved three medications for use in treating opioid dependence: methadone, buprenorphine, and naltrexone. Extended release naltrexone, brand name Vivitrol®, is a once-monthly injection intended to help prevent relapse to opioid use. Read this fact sheet for more information on naltrexone.

Friday: New Mexico Legislative Committees to Hear About Heroin Assisted Treatment

International Expert Dr. Eugenia Oviedo-Joekes and the Drug Policy Alliance to Testify on the Alternative Treatment for Chronic Heroin Addiction

Santa Fe – On Friday, international expert Dr. Eugenia Oviedo-Joekes and Lindsay LaSalle, from the Drug Policy Alliance will testify at a joint meeting of the Interim Legislative Health and Human Services and Courts, Corrections and Justice Committees.  They will present on Heroin Assisted Treatment, an evidenced-based treatment for chronic heroin addiction. Heroin maintenance may be a feasible, effective and cost-effective strategy for reducing drug use and drug-related harm among long-term heroin users in New Mexico for whom other treatment programs have failed.


Emily Kaltenbach, 505-920-5256, ekaltenbach@drugpolicy.org

Tuesday: Maryland House of Delegates to Hold Groundbreaking Hearings on Two Harm Reduction Bills

One Bill Creates a Safe and Supervised Space for People to Use Drugs; The Other Would Establish a Pilot Program to Treat Opioid Dependence with Poly-Morphone Therapy

Proposals are Part of Groundbreaking Package of Harm Reduction Drug Policy Bills That Would Also Decriminalize Small Amounts of All Drugs and Provide Treatment-at-Need in ER’s and Hospitals

Tuesday at 1pm, the Maryland House of Delegates will hold legislative hearings on two progressive legislative proposals aimed at treating drug use as a health issue. House Bill 1212 permits the establishment of safe consumption programs, which allow individuals to consume controlled substances in a safe space, provide sterile equipment, and connect patients to treatment, medical care, and other social services.


Delegate Dan Morhaim, 410-841-3054
Lindsay LaSalle, 510-679-2315
Tony Newman, 646-335-5384

Amid Growing Support for Public Health, Versus Criminalization Approaches to Drug Use, Governor Cuomo Signs Bill to Expand Methadone and Suboxone Treatment in New York Drug Courts

Experts Recommend New York Embrace Evidence-based, Public Health Approaches to Address Opioid Use and Overdose

Bill Follows Obama Administration Recommendation to Expand Medical Assisted Treatment

Albany — Last Friday, New York Governor Cuomo signed legislation to prohibit drug court judges from forcing defendants suffering from opioid dependency to stop using medication-assisted treatment (MAT), such as methadone or Suboxone, as a condition of avoiding prison, and affirms the value of these medications in drug treatment. Sponsored by Democrat Linda Rosenthal in the Assembly and Republican Terrence Murphy in the Senate, the bill  (S.4239-B/A.6255-B) passed both the Senate and Assembly with overwhelming, bipartisan support last June.


Kassandra Frederique (646) 209-0374
Matt Curtis (646) 234-9062

Harm Reduction and Human Rights: Strategies on Expanding Harm Reduction Through Human Rights

May 20, 2015

Watch the recording now!

Harm reduction services and syringe exchange are more than just a prevention strategy. Access to these vital services enables HIV testing, linkage to care and other critical health/social services, as well as affirming the human rights and dignity of people who use drugs.

NJ Governor Chris Christie Signs Bill Expanding Access to Evidence-Based Drug Treatment for Participants in Drug Courts

Legislation Permits Participants to Complete Drug Court While Using Medication Assisted Treatment Such as Methadone and Buprenorphine

Advocates Cheer Signing as Triumph of Good Public Health Policy and Lifesaving Reform

Trenton—Today Governor Chris Christie signed into law Senate Bill 2381/Assembly Bill 3723, which permits successful completion of drug court for those who are utilizing medication assisted treatment (MAT) for substance use disorders. The legislation gained bipartisan sponsorship and unanimous approval in the Legislature before reaching the Governor’s desk.


Tony Newman 646-335-5384
Roseanne Scotti 609-610-8243

Prestigious Study Found Heroin-Assisted Treatment Produces Benefits to Individuals and Society

Study Focused on Six Countries and Found Reductions in Illegal Drug Use, Crime and Health Care Costs Without Harming Public Safety

Nevada State Senate Considered Legislation for Heroin-Assisted Treatment Trial Project

A seminal review recently published in the prestigious British Journal of Psychiatry confirms that heroin-assisted treatment, also known as supervised injectable heroin treatment or heroin-maintenance, is an effective treatment for patients who have not responded to standard treatment options such as methadone or residential rehabilitation. Heroin-assisted treatment refers to the supervised administration of pharmaceutical-grade heroin to a small group of particularly difficult-to-treat chronic heroin users.


Lindsay LaSalle 510-847-8064
Tony Newman 646-335-5384

Testimony of Ethan Nadelmann in Support of a Heroin-assisted Treatment Pilot Program in Nevada

April 7, 2015

On April 7, 2015, Ethan Nadelmann, Executive Director of the Drug Policy Alliance, presented oral testimony in support of sections 11-20 of SB275 at a hearing of the Nevada State Senate Revenue and Economic Development Committee. Nadelmann also submitted complementary written testimony. SB275 would create a four-year heroin-assisted treatment pilot program—the first in the United States. Heroin-assisted treatment is a feasible, effective, and cost-saving strategy for reducing drug use and drug-related harm among long-term heroin users for whom other treatment programs have failed.

Colorado Opioid Symposium: Reducing the Impacts of Opioids in Colorado

Members of the Affected Community, International Experts, Treatment Providers, State Leaders and Physicians Gather to Discuss Opioid Use, Harm Reduction Strategies, Overdose Prevention, Supervised Injection Facilities, Heroin Assisted Treatment and Best Practices From Around the World

Daylong Symposium to be Held at Denver’s History Colorado Center, Thursday, March 5, 8:30 a.m. – 4:30 p.m.

Denver, CO – The Drug Policy Alliance, Harm Reduction Action Center and the Center for Public Health Practice will convene stakeholders to deliberate on the current impact of opioids and more effective responses to opioid use and dependency in Colorado.  The Opioid Symposium is a daylong event on Thursday, March 5th at the History Colorado Center in Denver.


Art Way, 720-288-6924

Taking Control: Pathways to Drug Policies That Work

September 8, 2014
Global Commission on Drug Policy

This report reflects a new evolution in the thinking of the Global Commission, which includes Kofi Annan, Richard Branson, and the former presidents of Brazil, Chile, Colombia, Mexico, Poland, Portugal and Switzerland. They not only reiterate their demands for decriminalization, alternatives to incarceration, and greater emphasis on public health approaches – but now also call for responsible legal regulation of currently-illegal drugs.

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