Programme for treatment with opioid agonists and agonist-antagonists of people dependent on opioids
The Programme is completely based on the international standards for good clinical practice in methadone maintenance
programmes and the requirements of the regulatory document number 24/31.10.2000 of the Ministry of Healthcare
Dr Krum Jordanov is the programme team leader
Team:
Dr Dafin Petrov Nenov - psychiatrist
Dr Mariana Vassileva Petrova - psychiatrist
Dr Hristo Miykov Hristov – clinical consultant
Rada Dimitrova Kostova - psychologist
Elmira Georgieva Parcheva - psychologist
Dessislava Todorova Atanassova – social worker
Silvia Dimitorva Krusteva - nurse
Aneta Petrova Padareva - nurse
Timetable of the team: Monday to Friday: 7:30 To 13:30 h
Supplying methadone: 08.00 to 13.00 h
Objectives and main tasks:
Methadone Programme has the following objectives and main tasks:
1. Prevention of health and social damage occurring as a result of chronic psychoactive substance abuse
2. Correction and treatment of physical, behavioral and psychiatric disorders due to chronic psychoactive substance abuse
3. Reduction of abuse and parenteral use of psychoactive substances
4. Limitation of criminal behavior associated with psychoactive substance abuse
5. Reduction of the severity of psychoactive substance dependence
6. Achieving and maintenance of an acceptable level of medical, familial and social functioning
7. Protection of public health by reducing the risk of infection and spread of AIDS, hepatitis and other blood transmitted diseases.
The duration of treatment is long term and is determined by individual assessment and treatment plan.
Admission of patients to the Programme is organized according the following steps:
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Accepting the application
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Placement on the waiting list
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Review of the application by the Programme Admission Committee
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Preliminary work in order to inform and motivate the patient for participation in the Programme
Patient admission is granted by a Committee appointed by the Programme Leader consisting of three members. For each admission a protocol is created.
Basic inclusion criteria for the Programme are as follows:
1. Patient should be minimum 18 years old
2. Evidence of existing dependence on opioid agonists and/or agonists-antagonists
3. Regular abuse of psychoactive substances in the course of three or more years
4. Intravenous use of opioids in the course of minimum one year
5. Minimum three attempts for treatment in different therapeutic programmes without success or permanent discontinuation of psychoactive substance abuse
6. A valid identity certifying document
7. Permanent address registration in Veliko Tarnovo or other settlements with good transport links in order to daily visit the Programme
8. Absence of pending criminal court cases
9. Presence of family and/or other supportive environment with readily declared willingness to cooperate in the therapeutic
10. Availability for daily visits to the Programme
Priority for the Programme inclusion have patients who have some of the following medical indications: pregnancy, infection with HIV, Hepatitis B and/or C viral infection.
Patient discharge from the Programme occurs at the completion of treatment with a reduction plan for a period of six months or more.
It can occur also following violation of the rules of the Programme or unsatisfactory results of treatment, following patient's request for discharge or due to patient’s entry to a controlled facility (Investigation Service, prison, etc.).
Patient administrative discharge following Programme rules violation takes place after 21- or 30-day long detoxification.
In cases of administrative discharge, entry to a controlled facility of long term hospitalization, patients are discharged after 21-day long detoxification. Detoxification period can span a longer period if medical indications are present
In case of severe rules violation requiring immediate discharge, the Team does not provide dose reduction.
The medication used in the Programme is Methadone Hydrochloride in solution.
The individual dose is determined after a strict assessment on behalf of the treating physician.
Programme Scope
The Programme can comprise 40 patient places, 5 of which are provided with priority for pregnant women and mothers with small children, socially disadvantaged patients or patients infected with HIV, severe blood transmitted infections and patients with acute need for methadone treatment due to a serious health condition.
Contact phone: 062 62 56 97