Community based support

 

Treatment within the community is the preferred option for treatment whereby patient care is co-ordinated by a specialist with the aim of stabilising opioid use through pharmacological treatment. This should also consist of psychosocial interventions, such as group therapy or cognitive behavioural therapy and the user should be appointed a keyworker.

 

Contingency management can also be carried out in the community, which aims to reduce illicit drug use and promote engagement with methadone maintenance by offering monetary incentives (shopping vouchers) or privileges (take home methadone doses) for negative drug tests and partaking in harm reduction methods, such as HIV testing and Hepatitis B immunisation, thus activating the dopamine reward system for drug abstinence; however, this is not commonly used in the UK.