Harm reduction for opiate addiction reduces HIV risk

By ACSH Staff — Oct 17, 2012
Potency of some drugs may exceed expiration dateMethadone has been shown to reduce the risk of HIV transmission in people who inject drugs, according to a study published in BMJ.

Potency of some drugs may exceed expiration dateMethadone has been shown to reduce the risk of HIV transmission in people who inject drugs, according to a study published in BMJ. The meta-analysis of several published and unpublished studies from nine countries concluded that making methadone available to injectible drug users reduced their HIV risk by 54 percent.

Synthetic opiates taken orally, such as methadone, act upon opiate receptors and provide many of the same effects as potent opiate drugs, but without most of the obvious downsides, especially transmission of infections. One use for synthetic opiates is opiate substitution therapies in which an illegal opiate drug is replaced with a longer acting but less euphoric opiate, such as methadone.

The international team of researchers credit opiate substitution therapies with the decline in HIV infection risk. Co-author Dr. Julie Bruneau from the University of Montreal, says the importance of this study comes from the fact that not only does opiate substitution therapy reduce HIV transmission in people who inject drugs in countries where there is a high rate of HIV, but also in Quebec, which has recently seen a rise of intravenous use of illicit opiates, and where finding substitute opiate therapy is problematic.

This seems quite obvious, says ACSH s Dr. Elizabeth Whelan. It makes perfect biological sense five to 10 percent of HIV infections worldwide are contracted because of injection drug use, thus, if you get users off the needle, there is going to be a reduction in HIV.

This is simply the concept of harm reduction employed against the often devastating effects of intravenous drug addiction, added ACSH s Dr. Gilbert Ross. A similar approach to the vastly larger problem of nicotine addiction from cigarettes should be similarly effective using reduced harm nicotine delivery methods, such as smokeless and dissolvable tobacco, and e-cigarettes.

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