Study Focused on Six Countries and Found Reductions in Illegal Drug Use, Crime and Health Care Costs Without Harming Public Safety
Nevada State Senate Considered Legislation for Heroin-Assisted Treatment Trial Project
A seminal review recently published in the prestigious British Journal of Psychiatry confirms that heroin-assisted treatment, also known as supervised injectable heroin treatment or heroin-maintenance, is an effective treatment for patients who have not responded to standard treatment options such as methadone or residential rehabilitation. Heroin-assisted treatment refers to the supervised administration of pharmaceutical-grade heroin to a small group of particularly difficult-to-treat chronic heroin users.
The review by John Strang and colleagues, titled “Heroin on trial: systematic review and meta-analysis of randomised trials of diamorphine-prescribing as treatment for refractory heroin addiction,” evaluated the findings of six randomized controlled trials on supervised injectable heroin treatment in six different countries (Switzerland, The Netherlands, Spain, Germany, Canada, and England) and FOUND that, across all trials, there was a greater reduction in the use of illicit ‘street’ heroin in patients receiving pharmaceutical heroin compared to the control groups (who generally only received methadone).
The review concluded that, “heroin-prescribing, as a part of highly regulated regimen, is a feasible and effective treatment for a particularly difficult-to-treat group of heroin-dependent patients.”
Moreover, this positive treatment outcome was coupled with, in many trials, a considerable economic benefit because of the reduction in the costs of criminal procedures, imprisonment and healthcare, as well as no negative effects of the supervised injecting clinics on public safety.
“The feasibility and effectiveness of heroin-assisted treatment has, once again, been borne out in the scientific literature,” said Lindsay LaSalle, a harm reduction attorney with the Drug Policy Alliance. “The question that remains is not whether heroin maintenance is backed by science, but whether it will ever be backed by politicians and government officials in the United Sates. As of now, the only thing that stands in our way is ideology and stigma.”
A significant step forward, however, was taken this past spring when Nevada State Senator Tick Segerblom introduced groundbreaking legislation, Senate Bill 275, which proposed the creation of a four-year heroin-assisted treatment pilot project. Though the bill failed to pass, it represented the beginnings of a potential paradigm shift wherein drug use is treated as a health issue and scientifically proven treatments are made available to those who could benefit. The recent review by Strang et al. should inspire similar efforts.