Methadone Maintenance Treatment

What is the impact of Opioid Dependence?

People who are dependent on opioids often lead extremely stressful and chaotic lives, and frequently experience serious health and social problems as a result of their dependence. They are at high risk of premature death from accidental drug overdose, drug-related accidents, or violence. Sharing needles, syringes, straws, cookers or other contaminated drug-taking equipment, for example, places them at high risk of acquiring human immunodeficiency virus (HIV), hepatitis C virus (HCV) or other blood-borne pathogens.

The problem of opioid dependence may be exacerbated by multiple substance use, as well as factors such as poverty and homelessness. Mental health disorders--such as depression, antisocial personality disorder and anxiety disorders--are also common. Often, people who are dependent on opioids have experienced a long history of rejection, exclusion and incarceration, which reinforces their sense of alienation and antagonism. They may have little sense of control over their lives.

Opioid dependence is also a costly social problem. The number of people in Canada who regularly use heroin has been estimated at between 40,000-90,000.² Untreated, opioid dependence involves significant costs related to criminal activity, medical care, drug treatment, lost productivity, and an increase in the transmission of HIV, HCV and other blood-borne pathogens.³ In 1996, approximately half of the estimated 4,200 new HIV infections that occurred in Canada were among injection drug users.⁴ According to the Laboratory Centre for Disease Control⁵, at least 70% of prevalent HCV infections are related to injection drug use. Some populations of individuals who are dependent on opioids are particularly vulnerable to the dual problem of injection drug use and infection with HIV, HCV or other blood-borne pathogens including women, street youth, offenders in correctional facilities, and Aboriginal people.⁶

Overall, illicit drug use cost an estimated $1.37 billion in Canada in 1992, and about 70% of this (or $48 per capita) was attributed to opiate use.⁷ The lifetime costs of treating HIV infection in one person are estimated at $153,000.⁸