Drug replacement and maintenance therapy have a long history of providing individuals struggling with problematic drug use with legal access to drugs that would otherwise be obtained through illegal means.
The Centers for Disease Control and Prevention, the Institute of Medicine, the Substance Abuse and Mental Health Service Administration (SAMHSA), the National Institute on Drug Abuse (NIDA), the World Health Organization and over four decades of government-funded, peer-reviewed medical research have unequivocally and repeatedly proven that replacement therapies like methadone maintenance are the most effective treatments for opioid dependence.
Methadone and Buprenorphine
Methadone is the most widely-used maintenance treatment. Used properly, methadone reduces drug use and related crime, death, and disease among heroin users. But methadone has been handicapped by restrictive government regulations, by misinformation - among treatment providers and drug users alike - and by prejudice against methadone treatment.
Methadone is the most tightly restricted drug in the U.S. Doctors in general medical practice can't prescribe methadone, and regular pharmacies don't distribute it.
Buprenorphine is a newer medication that has also been shown to be effective and it can be prescribed by physicians who have gone through special training.
The Drug Policy Alliance advocates for making both methadone and buprenorphine more accessible, through changing attitudes, laws, regulations, and health insurance policies. Funding must be increased for access to methadone and buprenorphine through the public health system for those who cannot afford it otherwise.
Heroin-Assisted Treatment (HAT)
For drug users who have not found success with methadone, the most dramatic developments in drug substitution therapies have been in the field of Heroin-Assisted Treatment (HAT). HAT programs, as part of comprehensive treatment strategies, provide substantial benefits to long-term heroin users who have not been responsive to other treatment.
Studies have shown that those enrolled in HAT demonstrate a reduction in drug use and an improvement in overall physical and mental health. Additionally, several studies have found that individuals who participated in these programs significantly reduced their involvement in criminal activities, generating large cost savings.
Heroin maintenance may be a feasible, effective and cost-effective strategy for reducing drug use and drug-related harm among long-term heroin users for whom other treatment programs have failed.
One Bill Creates a Safe and Supervised Space for People to Use Drugs; The Other Would Establish a Pilot Program to Treat Opioid Dependence with Poly-Morphone Therapy
Proposals are Part of Groundbreaking Package of Harm Reduction Drug Policy Bills That Would Also Decriminalize Small Amounts of All Drugs and Provide Treatment-at-Need in ER’s and Hospitals
Tuesday at 1pm, the Maryland House of Delegates will hold legislative hearings on two progressive legislative proposals aimed at treating drug use as a health issue. House Bill 1212 permits the establishment of safe consumption programs, which allow individuals to consume controlled substances in a safe space, provide sterile equipment, and connect patients to treatment, medical care, and other social services.
Experts Recommend New York Embrace Evidence-based, Public Health Approaches to Address Opioid Use and Overdose
Bill Follows Obama Administration Recommendation to Expand Medical Assisted Treatment
Albany — Last Friday, New York Governor Cuomo signed legislation to prohibit drug court judges from forcing defendants suffering from opioid dependency to stop using medication-assisted treatment (MAT), such as methadone or Suboxone, as a condition of avoiding prison, and affirms the value of these medications in drug treatment. Sponsored by Democrat Linda Rosenthal in the Assembly and Republican Terrence Murphy in the Senate, the bill (S.4239-B/A.6255-B) passed both the Senate and Assembly with overwhelming, bipartisan support last June.
Harm reduction services and syringe exchange are more than just a prevention strategy. Access to these vital services enables HIV testing, linkage to care and other critical health/social services, as well as affirming the human rights and dignity of people who use drugs.
Legislation Permits Participants to Complete Drug Court While Using Medication Assisted Treatment Such as Methadone and Buprenorphine
Advocates Cheer Signing as Triumph of Good Public Health Policy and Lifesaving Reform
Trenton—Today Governor Chris Christie signed into law Senate Bill 2381/Assembly Bill 3723, which permits successful completion of drug court for those who are utilizing medication assisted treatment (MAT) for substance use disorders. The legislation gained bipartisan sponsorship and unanimous approval in the Legislature before reaching the Governor’s desk.
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.
On April 7, 2015, Ethan Nadelmann, Executive Director of the Drug Policy Alliance, presented oral testimony in support of sections 11-20 of SB275 at a hearing of the Nevada State Senate Revenue and Economic Development Committee. Nadelmann also submitted complementary written testimony. SB275 would create a four-year heroin-assisted treatment pilot program—the first in the United States. Heroin-assisted treatment is a feasible, effective, and cost-saving strategy for reducing drug use and drug-related harm among long-term heroin users for whom other treatment programs have failed.
Members of the Affected Community, International Experts, Treatment Providers, State Leaders and Physicians Gather to Discuss Opioid Use, Harm Reduction Strategies, Overdose Prevention, Supervised Injection Facilities, Heroin Assisted Treatment and Best Practices From Around the World
Daylong Symposium to be Held at Denver’s History Colorado Center, Thursday, March 5, 8:30 a.m. – 4:30 p.m.
Denver, CO – The Drug Policy Alliance, Harm Reduction Action Center and the Center for Public Health Practice will convene stakeholders to deliberate on the current impact of opioids and more effective responses to opioid use and dependency in Colorado. The Opioid Symposium is a daylong event on Thursday, March 5th at the History Colorado Center in Denver.
Global Commission on Drug Policy
This report reflects a new evolution in the thinking of the Global Commission, which includes Kofi Annan, Richard Branson, and the former presidents of Brazil, Chile, Colombia, Mexico, Poland, Portugal and Switzerland. They not only reiterate their demands for decriminalization, alternatives to incarceration, and greater emphasis on public health approaches – but now also call for responsible legal regulation of currently-illegal drugs.
Under HAT, pharmacological heroin is administered under strict controls in a clinical setting to those who have failed in other treatments like methadone. Every published evaluation of HAT has shown extremely positive outcomes: major reductions in illicit drug use, crime, disease and overdose; and improvements in health, wellbeing, social reintegration and treatment retention. More than a half dozen countries in Europe and Canada have implemented heroin-assisted treatment (HAT) programs.
There is an extensive body of literature documenting the stigma associated with alcohol and other drug problems. No physical or psychiatric condition is more associated with social disapproval and discrimination than substance dependence. For people who use drugs, or are recovering from problematic drug use, stigma can be a barrier to a wide range of opportunities and rights.