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Opioid agonist therapies (OAT) are highly effective treatments and are central to the reduction of harm associated with illicit opioid use, but access to and retention in treatment is made difficult by burdensome rules and requirements. A prescriber of OAT needs to be confident that the risks of prescribing OAT to a person with a moderate or severe opioid use disorder are outweighed by the benefits thereof. The major risk pertaining to OAT is opioid overdose, which tends to occur in complex environments and often involves multiple drug toxicity. The benefits of OAT, however, might include a reduction in the lifetime risk of overdose and reduced injecting‐related harms, and also improved physical, psychological and social wellbeing. Individuals who are engaged in OAT might experience a reduction in harms associated with opioid use without necessarily changing their substance use. Abstinence from opioids or other substances may be the goal of a particular individual, but it is not a universal goal and it should not be a condition of OAT.

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Authors: Ashleigh Shipton, Meredith O'Connor, Melissa Wake, Sharon Goldfeld, Helen Lees, Catina Adams, Kristina Edvardsson, Leesa Hooker, Jatender Mohal, Rhiannon M Pilkington and Fiona K Mensah

Article Type: Perspective