Choice of substitution therapy in HIV positive opiate addicts

Abstract – Croatia is a country that, despite the »war« epidemic of opiate addiction, has continuously had a very low incidence of the disease and the proportion of seropositive iv. opiate addicts is very low and has shown a stable trend (0.5% in 2009 and 2010). N.N. (30) was raised in an urban dysfunctional family. He has been an intravenous heroin addict since he was 16. Before hospital admission, he was on maintenance therapy with methadone. HIV and hepatitis C infection were diagnosed one year ago. The patient was referred for hospital treatment due to the indicated transfer to buprenorphine therapy. When applying the transfer from high methadone doses to buprenorphine there is a risk of severe withdrawal syndrome. In order to ensure and facilitate the transfer, a standardized method was developed at the Department: it shortens the time and reduces the transfer risk from high methadone doses to buprenorphine. The transfer from methadone to buprenorphine is indicated in HIV – positive opiate addicts because of significantly less adverse drug interactions in the case of antiviral therapy implementation.