Access to Heroin a Boon to Refractory Addicts

By Lowry, Fran | Clinical Psychiatry News, March 2009 | Go to article overview

Access to Heroin a Boon to Refractory Addicts


Lowry, Fran, Clinical Psychiatry News


BOCA RATION, FLA.--Supervised access to heroin improved the physical and mental well-being of chronic heroin addicts who were refractory to methadone maintenance treatment in Dutch and Candian studies.

In the Dutch studies, heroin-assisted treatment consisting of inhalable or injectable heroin prescribed over a 12-month period along with methadone was significantly more effective in improving physical health, mental status, and social functioning than was treatment with methadone alone, Dr. Wim van den Brink said at the annual meeting of the American Academy of Addiction Psychiatry.

These parameters improved in 50% of patients who got heroin plus methadone, compared with 27% of patients who got methadone maintenance alone in the inhalable study group, and in 56% of patients who got heroin plus methadone, compared with 31% of patients who got methadone maintenance alone in the injectable study group, said Dr. van den Brink, professor of psychiatry at the University of Amsterdam.

To be included, patients had to be chronic treatment-resistant heroin addicts. Their mean age was 39 years and 80% were male. They had been addicted to heroin for at least 16 years and had been using heroin 26 days of the last 30 days before entering the study. They had also been on methadone maintenance treatment for at least 12 years and had been using it 29 days out of the last 30 days before entry into the study. Ninety-two percent also were cocaine addicts and had used cocaine within 18 days of study entry. Of the total, 60% had physical problems, 60% had psychiatric problems, and 72% had social problems.

Patients randomized to heroin-assisted treatment with inhalable heroin (375 patients) or intravenous heroin (174 patients) could visit one of six clinics in Amsterdam three times a day, 7 days a week, and receive up to 1,000 mg/ day of heroin plus 150 mg of oral methadone. Those in the methadone-only group received 150 mg of oral methadone daily.

Patients were deemed responders if they experiences a 40% or greater improvement in their physical health, mental status, or social functioning. …

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