AuthorEuropean Monitoring Centre for Drugs and Drug Addiction (EU body or agency)
TECHNICAL REPORT | Balancing access to opioid substitution treatment with preventing diversion of medications
Opiate: one of a group of alkaloids derived from the opium poppy (Papaver somniferum) with
the ability to induce analgesia, euphoria and, in higher doses, respiratory depression and coma.
The term excludes synthetic opioids.
Opioid: a generic term applied to alkaloids from the opium poppy (Papaver somniferum), their
synthetic analogues and compounds synthesised in the body that interact with specific
receptors in the brain and have the ability to induce analgesia, euphoria (a sense of well-being)
and, in higher doses, respiratory depression and coma.
Opioid agonist: any morphine-like substance that produces effects that mimic the action of the
naturally occurring substance, including pain relief and respiratory depression.
Opioid antagonist: a substance (e.g. naloxone and naltrexone) that blocks mu, kappa or delta
opioid receptors, used primarily in the treatment of opioid-induced respiratory depression.
Opioid substitution treatment (maintenance treatment): a treatment for opioid dependence
that uses relatively stable doses of long-acting opioid agonists (usually methadone or
buprenorphine) prescribed over prolonged periods of time (usually more than 6 months), which
stabilises brain functions and prevents craving and withdrawal.
Overdose: an accidental or intentional use of any drug in an amount that produces acute
adverse physical or mental reactions transient or lasting or death; the lethal dose of a
particular drug varies depending on the individual and the circumstances.
Prescribed opioid medications (e.g. methadone and buprenorphine): medications that are
prescribed by a licensed physician to a patient and dispensed by a pharmacy.
Prescription (or prescribable) opioids: opioid medications that are intended to be prescribed
as medicines and that can be diverted anywhere in the system without necessarily being
Withdrawal syndrome: the occurrence of a complex syndrome of uncomfortable symptoms or
physiological changes caused by an abrupt discontinuation or a dosage decrease after repeated
administration of a pharmacological agent. Withdrawal syndrome can also be caused by the
administration of an antagonist.
ACMD (Advisory Council on the Misuse of D rugs) (2015), How can opioid subs titution therapy (and drug
treatment and recovery systems) be opt imised to maximise recovery outc omes for service users?,
ACMD, London.
Aitken, C., Higgs, P. and Hellard, M. ( 2008), Buprenorphine injection in Mel bourne, Australia: an update,
Drug and Alcohol Review 27(2), pp. 197-199.
Alho, H., DAgnone, O., Krajci, P., McKeganey , N., Maremmani, I., Reimer, J., Roncero, C., et al. (2015),
The extent of misuse and diversion of medication for agonist opioid treatmen t: a review and expert
opinions, Heroin Addiction and Related Clinical Prob lems 17, pp. 25-34.
Allen, B., and Harocopos, A. (2016), Non-Prescribed Buprenorphine in New Y ork City: Motivations for
use, practices of diversion, and exper iences of stigma’, Journal of su bstance abuse treatment, 70,
pp. 8186.
Amato, L., Davoli, M., Perucci, C. A., F erri, M., Faggiano, F. and Mattick, R. P. (2005) , An overview of
systematic reviews of the effectivenes s of opiate maintenance therapies: available evidence to
inform clinical practice and researc h, Journal of Substance Abuse Treatm ent 28(4), pp. 321-329.

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