Opioid dependence

Opioid dependence is increasing globally and in South Africa. It is characterised by physical dependence on opioids, e.g. tolerance and withdrawal, and loss of control over opioid use. In addition to the use of illicit opioids, such as heroin, there is escalating abuse of prescription and over-the-counter opioids, such as codeine. It is now widely accepted that opioid dependence is a chronic condition, and that many patients follow a relapsing and remitting pattern. Opioid dependence is treatable, and long-term comprehensive care leads to the best outcome. An understanding of the neurobiology of the disease and the important role of maintenance pharmacotherapy is required for treatment. This article discusses opioid dependence and suggests a role for the community pharmacist in managing this complex disorder. (C) Medpharm