Context: The state government in Punjab is banking on Outpatient Opioid Assisted Treatment Centres (OOAT) to curb the drug menace in the state.
What are the OOAT Centres?

• The move to set up OOAT centres in Punjab began in October 2017.
• The centres administer de-addiction medicine, a combination of buprenorphine and naloxone, to the opioid-dependent people registering there.
• Administered in the form of a pill, the treatment is primarily for addicts of opioid drugs, including heroin, poppy husk and opium.
• There are such private and state-run centres in Punjab.

Why is the Punjab government planning?

• Punjab is planning to open OOAT linked extension centres and clinics in rural areas to broaden the outreach of this treatment.
• The idea is that patients get medicine nearer their place of residence.
• It will also reduce pressure on existing OOAT centres which cater to patients from far off places.

Administering medicine at OOAT Centres

The patients are broadly put into three categories or phases.

• In the induction phase, the newly-registered patients are administered medicine at the OOAT centres for a week or two to manage withdrawal symptoms in the presence of the doctor and counsellor.

In second, stabilization, phase, which extends between two to four months.

• The patient is put on watch for taking any opioid-based “super-imposed” illicit drug and accordingly maximum tolerated dose is administered to nullify the kick of the “super-imposed” drug.

In the third, maintenance, phase, the patient is given take-home medicine and it continues for a year and half before assessment is done to see whether the medicine can be tapered off.

Why is Punjab banking so much on OOAT therapy?
There are two major approaches to wean away opioid-dependent persons.

• One is the abstinence approach and another alternate medication approach.
• There are more chances of relapse in abstinence-based approach as compared to alternate medication for de-addiction.
• In the abstinence approach, it would have taken years to rehabilitate patients by admitting them in facilities and there would have been increased chances of relapse.
• On the other hand, alternate medication approach has been acknowledged as better in various scientific studies worldwide.