OST (Opioid Substitution Therapy) services for Drug Users mooted
Source: The Sangai Express

Imphal, December 14 2012: "Opioid Substitution Therapy or OST is the best option today for injecting drug users and we will do whatever we can to scale it up", assured Manipur state AIDS Control Society's Project Director Dr Shailesh Kumar Chaurasia while speaking at a workshop on 'North East States Consultation for Dissemination of experiences of NGO-led OST in Manipur and Nagaland Implemented by Project ORCHID' .

besides Dr Chaurasia, Dr.Nandira Changkija, Project Director, Nagaland State AIDS Control Society (NSA-CS), representatives of NACO-NERO, Guwahati, drug users and positive networks and NGOs working in the field of drugs and HIV & AIDS attended the day long Consultation organised by Project ORCHID.

officials from State AIDS Control Societies (SACS) of Assam, Meghalaya, Nagaland, Tripura and Mizoram also attended the consultation to learn from the experiences of the OST roll out in Manipur and Nagaland through community � NGO partnerships.

Pointing out poor coordination among NE states on skill sharing and relevant information Dr Changkija, who chaired the discussion session, recommended setting up of a core committee comprising SACS, NGOs and TSU representatives from all the NE states.

Such a committee will not only facilitate OST scale up but also facilitate knowledge sharing on a number of issues, she said adding "It's I, you and we who are failing to implement.

We need to share information for such a scale up and more importantly we need to involve all the stake holders" .

Speaking on the importance of continued scale up, Director, EHA-HIV/AIDS and Partnership Projects Dr Langkham stated, "a day of sobriety in the life of a drug user is important.

When we started OST people questioned us on the chances of success of the programme.

The programme was for one year.

Today not only are OST services continuing but it is being seen as an important treatment option by the community of injecting drug users.

We have achieved ten percent OST coverage in Manipur and aim to reach 20 percent soon" .

Point out need for community involvement Dr Suresh, consultant, said that OST is one of the priorities for NACO and an effective way for community involvement is being worked out.

"Single agency implementation of OST will not work; it has to be collaborative with involvement of various government and non government players at various levels," he said.

As part of the proposed scale up in Manipur, MSACS is assessing 19 sites where OST centres can be set up.

Four sites in Thoubal, Tamenglong, Moreh in Chandel district and Senapati have been approved and the centre in Senapati is already operational.

In this regard Dr Chaurasia underlining the importance of the OST programme for the North East states observed "we can't be content with NSEP and have to engage in various levels.

OST today is emerging as the most effective and accepted option among IDUs" .

In Nagaland, in addition to the existing OST sites supported by Project ORCHID and Nagaland State AIDS Control Society, NACO plans to set up more sites in Government health care settings based on a feasibility study report of the sites by NACO.

SACS officials from the north east states shared their experiences of rolling out OST in their respective states.

Community representatives also shared the impact that the OST program had on their lives.

It is said that in 2005, World Health Organisation (WHO) added Methadone and Buprenorphine to its list of essential medicines, and by 2010, 70 countries were implementing OST programmes as part of their harm reduction and HIV prevention strategy.

Despite WHO and UN agency endorsement for OST, it is estimated that only 8 percent of people who inject drugs receive OST worldwide thereby necessitating urgent need to learn from the successful experiences of programmes implementing OST and replicate it in similar settings.

In India, OST was introduced in 1993 and in Manipur and Nagaland Project ORCHID OST initiatives began in 2006.In Nagaland the OST clinics were implemented by Project ORCHID partner NGOs.

In all 13 OST clinics have reached out to 1800 IDUs across Manipur and Nagaland through Project ORCHIDs initiatives.

Results from Project ORCHID's experience of NGO and community partnership OST clinics in Manipur and Nagaland indicate that the program has achieved a very high regular attendance rate (91% recorded in 2011).This is due to high community involvement, comprehensive outreach services, strong counselling and a continued emphasis on family involvement and support.

Secondly, there has been a substantial improvement in the health practices of the IDUs who were reporting less risk behaviour as compared to before being on OST.

It was also found that the quality of life of drug users on OST was showing a substantial improvement.

They were attending social events, experiencing lesser family conflicts and there were lesser instances of incarceration and work absenteeism.

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