About opioid addiction

What is drug addiction?

Drug addiction is a mental disorder caused by addition to a narcotic substance or psychotropic substance  as a result of their abuse.

What is substitution maintenance therapy (SMT)?

The idea of SMT lies in daily long-term intake of a substitution drug for treatment of dysfunctions connected with consumption of poppy straw extract, heroin or other opioid drugs.

SMT is not intended for patients using stimulants, cannabis (marijuana) and other non-opioid psychoactive substances.

SMT aims at preventing the development of withdrawal syndrome in a patient, maintaining a stable condition of physical comfort and suppressing craving for illegal opioids.

SMT is a part of multimodality therapy when not only the problem of addiction but also other medical, psychological and social problems of a patient are resolved.

Intake of SMT drugs

Substitution drug Methadone is an only synthetic opioid with agonistic (i.e. similar to morphine and other opiates) properties, it is well absorbed by the gastrointestinal tract. Methadone is produced as a solution with different concentrations or as tablets.

Buprenorphine is a narcotic analgesic that blocks the action of other opioids and does not cause euphoria. It is produced in the form of a throat lozenge. Its time course is longer than that of Methadone.

Usually, the patients take Buprenorphine/ Methadone every day in the presence of a nurse, during the working hours of a healthcare facility where the patient is treated. The prescribed tablets (or solution) are ingested under the supervision of a nurse. The patients should be present in the office of substitution maintenance therapy (hereinafter – the SMT office) during the drug intake. A nurse shall control the process by examining the oral cavity to make sure that the medication was taken.

Side effects of long-term use of the medications may manifest in the form of increased perspiration, constipations, hypoactive desire in men, and dysmenorrhea in women.

Methadone  overdose may cause suppression of breathing function, respiratory disturbance and increased risk of death connected with them.

The use of other psychoactive substances (especially opioids, sleeping pills, tranquilizers, and alcohol) secondary to methadone substitution therapy increases the risk of overdose significantly!

During the substitution maintenance therapy, it is prohibited to drive vehicles and do the job that requires quick reaction, preciseness of movement or working at heights.


To participate in SMT, patients are medically registered on the basis of an id. The data on treatment can be provided to other persons in cases stipulated by the law, as well in cases a patient needs emergency medical care if he/she loses consciousness.

Rules of participation in substitution maintenance therapy

The patient is prohibited:

  • to consume alcohol, drugs or other psychotropic substances;
  • to carry cold gun or firearms;
  • to try to take out methadone/buprenorphin;
  • to disturb public order;
  • to commit any illegal actions with psychotropic substances, narcotic substances or precursors

For violation of the abovegiven rules the patient’s participation in the substitution maintenance therapy shall be terminated