It is assumed conceptually that the optimal treatment for opiate misuse starts with a comprehensive assessment of the patient to establish the severity of dependence and person's psychological and physical well being. Importantly, it is crucial to establish whether there is a co-morbid psychiatric condition such as depressive illness or personality disorder. It is also important to assess the patient's motivation and the degree of social support. This review focused on recent advances in pharmacotherapy of opiate misuse: short term and long term detoxification and maintenance therapy.