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No substitute for substitution 不能取代的代用治療

(updated on 2013/06/10)

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Methadone has long been proven to be an effective substitution medicine for treating heroin (or other opiate) dependence. Worldwide, good population coverage of substitution treatment protects societies from HIV transmission through injection drug use. Map shows the number of substitution treatment clients in European countries, against the corresponding opiate users population. Methadone is the commonest substitution medicine which was first introduced over 40 years ago. It has become available only very recently in a few countries. Whereas countries with a higher opiate users population generally have more drug users on substitution, the association is not a directly proportional one. Sustained effort is crucial in maintaining good coverage of methadone treatment in order to achieve effective harm reduction. Data sources for the map are: European Monitoring Centre for Drugs and Drug Addiction, World Drug Report 2010

美沙酮是有效的代用藥物，是治療海洛英及相關毒癮不可或缺的方法。在世界各地，高覆蓋的代用治療服務可以確保愛滋病毒不會經過吸毒者社群而擴散。地圖顯示歐洲代用治療覆蓋情況，當中餅圖代表各國接受代用治療人數，而背景顏色則是吸毒人數。在大部份歐洲國家，美沙酮是主要的代用藥物。代用治療在上世紀六十年代首先在一些國家推行，而部份國家在四十年後才引進。一般而言，吸毒人數高的地方同時較多人接受代用治療服務，但兩者關系並非成正比。要有效減低毒品禍害，必須系統地長時間推行高覆蓋的代用治療。地圖資料源自歐洲濫用藥物監察中心、聯合國毒品和犯罪問題辦公室《2010年世界毒品報告》。

Heroin addiction 海洛英毒癮

The term “addiction” is normally used to describe the habitual use of certain drug to the extent of becoming dependent on it. Withdrawal is often associated with very unpleasant physical and mental symptoms, making abstinence difficult. One commonest drug of addiction around the world is heroin, which is a synthetic form of opium. Heroin and related compounds are sometimes called “hard drugs”, compared to the newer substances of abuse called “soft drugs”, including amphetamine, ketamine and others. Terms like “use”, “abuse” and “dependence” are used to explain the condition of using addiction drug but of different contexts.
毒癮一般是指慣性服用某些藥物，繼而身體產生倚賴作用，停止用藥會令吸毒者經歷精神及肉體上極難受感覺，故此戒毒十分困難。海洛英是全球最常濫用的藥物，更被籠統視作硬性毒品，和興奮劑及K仔等軟性毒品分開。上了毒癮的也被形容為『使用』、『濫用』或『倚賴』毒品。

Methadone 美沙酮

Methadone can be used as analgesic, cough suppressant and anti-addictive maintenance in people who are on opioids. Back in the 1970s, in order to reduce drug dependence amongst heroin users, the Hong Kong Government established methadone maintenance programme and opened clinics to provide methadone to heroin users. Oral methadone has longer action (24 to 36 hours) as compared to heroin (6 to 8 hours). Its action is to occupy the brain receptor sites affected by heroin, thereby blocking the effects as well as relieving the craving and withdrawal symptoms. Methadone maintenance reduces unsafe needle sharing and potentially reduces blood borne infections. Methadone maintenance is a form of harm reduction measure, as it potentially reduces criminal offences associated with drug addiction and leads heroin users back to a normal life.
美沙酮可以用作為鎮痛藥、抑制咳嗽及用以治療有吸食海洛英等習慣的吸毒者。早於上世紀70年代，為了減少吸食海洛英使用者的毒癮，香港政府建立美沙酮診所提供美沙酮作為代用療法。口服美沙酮的藥效可以維持24至36小時，比海洛英（6至8小時）為長。在體內美沙酮佔據被海洛英影響的腦受體，阻止毒品發揮功效，大大減低倚賴及毒癮癥狀。口服美沙酮能減少因共用針筒而引起血液感染的傳染病。美沙酮代用療法有效幫助吸毒者回復正常生活，以及減少毒品買賣而引發的種種罪案問題。