Opioid Agonist Therapy (Substitution)

Are you using heroin or other opioids? And possibly other substances as well, such as alcohol, cocaine or prescription drugs? In our outpatient clinics, our experienced staff will support you in many different ways – even if, or especially if other substances are consumed in addition to heroin. Admission is quick and uncomplicated.

Our doctors and therapists will tailor the treatment to your personal needs in terms of:

  • which opioid agonist to choose
  • finding the right dosage for you
  • further support and treatments to deal with any additional social, mental or physical problems you may have

Extent and intensity of treatment will be adapted to suit your needs

Treatment stretches from discrete dispensing of drugs attached to minimal requirements all the way to closely monitoring your progress by our interdisciplinary teams. If required, a straightforward, medically assisted opioid detox as an outpatient is also possible.

Opioid agonist therapy

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The opioid agonist therapy uses medications with opioid effects. The treatment can be carried out with methadone, buprenorphine, morphine or L-Polamidon.

  • These substances can be tolerated well by one person but possibly not another, which is why it is crucial to choose the right substitute.
  • Dosage needs to be tailored individually to achieve a mental and physical balance and to avoid symptoms of withdrawal or overdose. For sustained treatment benefits and lasting stability, at least two years of treatment are recommended.
  • Methadone, morphine and buprenorphine are taken once daily.
  • Dispensing can be made easier by granting take-home medication on an individual basis.
  • If it is your goal to reduce the dosage gradually, in part or completely, we will support you.

Admission criteria

Opioid dependence (urine test before start of treatment)

Funding

The costs are covered in full by your health insurance.

Heroin-assisted treatment

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  • Pharmaceutical heroin (diacetylmorphine), unlike street heroin, is free of adulterants and contaminants.
  • Heroin can be dispensed in liquid form to be injected into the vein or the muscle, as tablets to be taken orally, or in a combination of the two.
  • There is also the possibility of combining heroin with an opioid agonist with long-lasting effect, such as morphine or methadone.
  • Under certain preconditions, heroin tablets can be taken home for self-administration.

Admission criteria

  • Two-year heroin dependence
  • At least 18 years old
  • Resident in the canton of Zurich
  • Two failed treatment attempts with other methods
  • Clinically indicated exceptions are possible.

Funding

Most of the costs are covered by your health insurance. In most cases, your town of residence will pay the rest.

Outpatient heroin detox

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At the request of the patient, Arud will evaluate, plan and carry out an outpatient heroin detox.

Aftercare – we continue to be there for you

After detoxification or after reducing the substitute, we will continue to help you reach your goals of abstinence or changing your consumption patterns for as long as necessary. We place particular emphasis on developing strategies with you to avoid relapses – and to find ways how to best deal with them, if they occur.

Contact

Would you like to get in touch or do you have any questions regarding treatment? We are there for you, with straightforward and confidential help.

+41 58 360 50 00
You can contact us from Monday to Friday from 8am to 6pm.
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Glossary

Buprenorphine

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Buprenorphine is a semi-synthetic opioid with long-acting effect (approx. 24 hrs), which is taken once daily. If the dose is increased accordingly, it is possible to take it once every two to three days. Buprenorphine is dispensed as tablets, which patients dissolve under their tongue. The opioid is absorbed in the oral cavity via the mucous membrane of the mouth.

Heroin

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Pharmaceutical heroin, unlike street heroin, is free of adulterants and contaminants. Heroin can be dispensed in liquid form to be injected into the vein or the muscle, as tablets to be taken orally, or in a combination of the two. It is also possible to combine heroin with an opioid agonist with long-lasting effect, such as morphine (Sevre Long®) or methadone. Under certain preconditions, heroin tablets can be taken home for self-administration.

Methadone

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Methadone is a synthetic opioid, which is dispensed as drinks, tablets or suppositories. It is taken once daily.

Morphine-Sulfate

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(retard release morphine, i.e. morphine with long-lasting effect) The chemical structure of morphine is closer to that of heroin than methadone. However, it causes less of a “rush” than heroin. Morphine is taken as capsules once a day.