The author presents a review of experience with substitution treatment in opiate dependence. Methadone treatment is most frequently used. An individual daily dose and long-term substitution are desirable for stabilization and motivation of patients included in the methadone programme. Interaction of methadone with some drugs affects the methadone metabolism and calls for a change of the methadone dose and must not be omitted. In addition to methadone there are also other types of pharmacotherapy of opiate dependence (acetylmethadol, buprenorphine). In the Czech Republic in 1997 in the General Faculty Hospital Prague the methadone programme was started. The importance of methadone substitution treatment is beyond doubt and involves improvement of the psychosocial and health status of addicts, gives an opportunity of resocialization and reintegration into society.

        Key words: drug addiction, treatment of opiate dependence, substitution treatment, drug interactions of methadone, methadone programme in the Czech Republic.