August 2003

From BMJ-British Medical Journal

Prescribing heroin can help treatment resistant addicts

Medical prescription of heroin to treatment resistant heroin addicts: two randomised controlled trials BMJ Volume 327, pp 310-12

Supervised prescription of a combination of methadone plus heroin is feasible, safe, and effective in reducing the many physical, mental, and social problems of heroin addicts, according to Dutch researchers in this week's BMJ.

Researchers in the Netherlands carried out two separate trials involving 549 heroin addicts who were not responding to methadone maintenance treatment. One trial used inhalable heroin and the other used injectable heroin.

Participants received either 12 months of methadone alone (control group), 12 months of methadone plus heroin (experimental group), or six months of methadone alone followed by six months of methadone plus heroin (comparison group). Psychosocial treatment was offered throughout.

In both trials, 12 month treatment with heroin plus methadone was significantly more effective than treatment with methadone alone. Many physical, mental, and social problems improved and few serious adverse events occurred.

"Our study provides strong evidence of the efficacy of prescribed heroin for addicts who are resistant to other forms of treatment," conclude the authors.



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