ABSTRACT
Harm minimization (HM) policies and interventions aim to reduce substance abuse-related problem behaviours. Goals of HM include improving access to care, treatment adherence, reductions in substance use, preventing diversion and misuse of pharmacotherapeutic and illegal drugs, reducing consequences of substance use, and integration of care. Harms of opioid use are avoidable and HM/ Opioid substitution treatment (OST) interventions are cost-effective. Direct pharmacological outcomes of OST include suppressing opioid withdrawal symptoms, and blocking the reinforcing effects of abused opioids if the patient self-administers them; this is termed pharmacological substitution. Some data suggest that OST retention might be improved by making care sensitive to gender, race, ethnicity and age. Psychiatric conditions are common among OST patients and complicate clinical management of opioid use disorders (OUD). Pregnant women in OST can benefit from interventions to reduce non-opioid substance abuse, which can yield future health benefits for the child.
