Medical heroin may be most effective treatment option to date
Wednesday, September 9th, 2009
Medical heroin may be the most effective treatment for treating opioid addiction, according to an American study.
When former users were treated with diacetylmorphine, the active ingredient in heroin, there was a 67 per cent reduction in illegal activity and illicit drug use after one year of treatment, compared to a 47.7 percent reduction with the treatment methadone.
The study, which was carried out at the University of British Columbia School of Population and Public Health in Vancouver, also found that retention rates in treatment programmes were higher for patients receiving diacetylmorphine - 87.8 per cent of patients taking diacetylmorphine were still enrolled on a programme after one year, compared to 54.1 percent who didn’t take it.
Dr. Martin Schechter, who carried out the research, said that diacetylmorphine was an effective alternative to methadone for patients who have failed to respond to previous treatment.
He believes that methadone should remain the standard treatment for most patients with opioid dependence, with diacetylmorphine reserved for the 15 percent to 25 percent who don’t respond.
“Methadone remains a pretty good first-line treatment,” he said, “but either the switch to heroin or using heroin as an adjunct obviously has increased effectiveness for this difficult population.”
Dr. Joshua Lee, from New York University, said the findings complement similar studies carried out in Europe - that medical heroin is a valid approach to treating addiction.
He said: “Generally it is a very positive development when a new treatment approach … brings drug users into a medicalized, therapeutic environment where further treatment can be established and related problems like cocaine use can begin to be addressed.”
However there are some critics to the use of diacetylmorphine and methadone as viable treatment options. Dr. Daniel Angres, psychiatrist and author of Healing the Healer: The Addicted Physician believes that alternatives such as bupronorphine should be more openly available.
Dr. Daniel Angres, psychiatrist and author of Healing the Healer: The Addicted Physician, questioned the usefulness of both diacetylmorphine and methadone as treatment options when an alternative with less abuse potential, bupronorphine, is available as the drug is less likely to be abused and the naloxone would block the opiate effect of bupronorphine if the drug were injected.