Stay Informed

Sign up for news & alerts

Already signed up?
Login here

take action
For every $1 states spend dollar sign on substance misuse and addiction, 94 cents go to shovel up the consequences instead of for treatment and prevention. TELL YOUR LEGISLATORS

What Can I Do?



Continuing Education
Free online courses for addiction counselors LEARN ONLINE

Get Help
Need alcohol or drug help for yourself or someone else? GET HELP

 

Heroin Maintenance Can Control Addiction, Study Concludes
August 24, 2009

Share Share Email
Email
Print
Print
SubscribeSubscribe
Research Summary

Heroin addicts who are given maintenance doses of the drug were more likely to remain in treatment and less likely to use street drugs or engage in other criminal activity than those receiving methadone, according to a study of a heroin-maintenance program in Canada.

The  New York Times reported Aug. 20 that researcher Martin T. Schechter of the School of Population and Public Health at the University of British Columbia said, "The main finding is that, for this group that is generally written off, both methadone and prescription heroin can provide real benefits."

After one year, 88 percent of the heroin-maintenance patients, who received doses of 450 milligrams of the drug, remained in the program and about two-thirds had greatly reduced their illicit activities, compared to 54 percent and 48 percent, respectively, among the methadone group.

However, the heroin group experienced more side-effects, including 10 overdoses. A total of 226 addicts took part in the study.

"Heroin works better than methadone in this population of users, and patients will be more willing to take it," said Joshua Boverman of the Oregon Health and Science University, a study co-author.

The study was published in the Aug. 20, 2009 edition of the New England Journal of Medicine.

This article summarizes an external report or press release on research published in a scientific journal. When available, links to the sources are provided above.

COMMENTS ON THIS ARTICLE:

Posted by Thomas A. Fischetti on 25 Aug 09 09:39 AM EDT
What happens when the addict needs more heroin due to increased tolerence? What does the addict do when the funding or the study ends??

Posted by SensibleCitizen on 25 Aug 09 10:33 AM EDT
Thomas- We shouldn't end the study. This should be our system of harm reduction.

Posted by John from Oceanside on 25 Aug 09 01:04 PM EDT
That is the problem with harm reduction. No one ever stops using drugs they don't get better they just live in the hell of addiction.

Posted by Tom from MA on 25 Aug 09 03:35 PM EDT
Interesting that there was no Suboxone control group. Wonder why.

Posted by Dave Kerr on 26 Aug 09 11:46 AM EDT
It is understandable why there was retention in treatment when addicts took IV herion. THERE MISSION IS TO GET HIGH AND HEROIN DOES THE JOB BEST! They reduced their illicit activity because heroin is provided for them. What this study is saying is no different than we would expect but where do we go with it? Do we switch addicts from methadone to heroin and when they want more, since they have stabilized and aren't getting high any more, what to we do? Heroin is not like methadone. You get high from it and you want more when you reach a stabilizing dose. If we don't give them more they will get it illegally since the are still ADDICTS WHO WANT TO GET HIGH AND THE HEROIN IS GETTING THEM HIGH. If we give them more, how much more? until they OD? Do we expect them to work while they are high on heroin? Stabilizing motivated addicts with methadone works; it won't work with heroin.

Posted by Christopher Cook on 27 Aug 09 09:25 AM EDT
Of course the patients stayed in treatment...we're injecting them with HEROIN! This is like quitting smoking by...smoking. I believe this just points to the stigma that addicts will never get clean; so let's just give them what they want. Most researchers are so far removed from the front lines they have no idea what they're talking about anymore. What ethical clinician would ever suggest to continue shooting dope? The proponents are discriminatory and its actually shocking to me. Clinical laziness has infected our field; it's disgusting.

Posted by JD Anticoli on 28 Aug 09 07:10 PM EDT
The main reason Methadone works so well for some as a maintenance drug is because of the self-limiting effect on tolerance resulting from methadone's NMDA activity in brain neurons which control the appetite for opiates. This, combined with the gratitude a methadone-maintained individual must maintain each day for feeling normal is the other essential reason it works superbly those individuals. Diacetylmorphine (heroin) has no such self-limiter affect in its chemical make-up. Hence, the addict who is DONE with getting high will find it very difficult to maintain any sense of normality without an ever-increasing dose of heroin. This I know, as someone whose only self-limiter when I was addicted to heroin…. was CASH.

Posted by Enrique Aponte on 31 Aug 09 12:18 PM EDT
"Heroine Maintenance Doses" Reminds me of the phrase... "Sleeping With The Enemy" Like reasoning with Cujo, the rabic dog.i.e. The Amsterdam proposal of 1983 for a regulated heroin prescription; 26 years later and not the solution.

Posted by David Bergstein on 01 Sep 09 11:46 AM EDT
The art of talk therapy is so lost that now we give them the drugs they are abusing! New therapy intervention: "Sir, you smoke crack? Ok, here is some crack."

Posted by Angie Wood on 01 Sep 09 11:47 AM EDT
The study reports that heroin had more side effects, including 10 overdoses!!! That in and of itself is NOT worth allowing "heroin maintenance" programs. I have seen methadone help many an addict experience some level of normalcy and stability. While it is not as ideal as abstinence, the individual should have a choice. Society still benefits from harm reduction. One size (i.e. abstinence) does not fit all. I am a bit removed from the literature on methadone therapies (I haven't worked in that field since 2001), but back then, I didn't feel there was enough information on WHO (what type of patient) best benefits from MM vs. detox and abstinence.

Posted by Wendy on 01 Sep 09 11:54 AM EDT
Is it me...or does this just appear to be feeding fuel to the fire, so to speak? As a recovering IV opiate/cocaine addict, I know how I would have felt if there had been an option like this for me: I would not have made the decision to quit. Quit...cease using the addictive drug. Not "continue to use to tolerate life" or "maintain without withdrawals." What is this saying to the youth in our nation?

Posted by Mike on 02 Sep 09 08:33 AM EDT
It is not suprising that addicts would remain engaged in a program that gives them their drug of choice. Particularly opiate addicts whose tolerance has caused them to need the drug in order to feel "normal". I have no real problem with dispensing heroin vs. methadone but believe that the ultimate goal should be abstinence. As long as a person with an addictive disorder is still ingesting a drug, he/she will never be able to fully realize the benefits of a bio-psycho-social-spiritual recovery.

Posted by MikeD on 02 Sep 09 11:22 AM EDT
If I am reading this correctly we nearly killed (maybe killed-not clear) 10 people to ultimately declare this approach is successful. How exactly can you get clearance from an IRB or Human Subjects committee on this type of recklessness? If this was the Swine Flu Vaccine we would take it off the market. My angst in all of these maintenance approaches is the apparent willingness to warehouse these populations. We are supporting in many cases and creating in others a class of zombies and celebrate our initiative and their "apparent" willingness to participate and call this ethical research. I say "apparent" because, in my professional opinion, in many of these cases there is no possibility an addicted participant is signing an informed consent, and no way that a treatment professional would support an argument to the contrary. I believe these approaches are misguided and dangerous.

Posted by Michael J. McFadden on 03 Sep 09 05:35 PM EDT
This certainly seems to make sense. After all, we all know that smoking is more addictive than heroin, right? And yet the Big Pharma companies and antismoking researchers all assure us that their "Nicotine Replacement Therapy" patches and gums are just fine and dandy to help folks stop smoking. So if we're dealing with a relatively mild addiction like Heroin, then "Heroin Replacement Therapy" should work even better, right? Er... unless someone's been lying to us of course. Michael J. McFadden, Author of "Dissecting Antismokers' Brains"

Posted by jrzshor on 09 Sep 09 10:56 AM EDT
lets try this experiment; let petty criminals break into houses under the supervision of a police officer and just take a few possessions from the house. i bet that the "price" of housebreaking will decrease. Insurance claimns will be "cheaper", court time will decrease, jail time will not happen. think of all the millions saved by controlled harm- reduction crime, oops, I mean activities not otherwise nice.

Posted by Anonymous on 22 Sep 09 04:41 PM EDT
Sounds like we're all giving up,just give them what they want,King Heroin you win!!

SUBMIT A COMMENT:

Note: Comments are now held for moderator approval. More info

Name:

Comment:
(limit 250
words)

Enter this word
(help):
Change

GUIDELINES: 
Please keep comments on-topic, courteous, clean, non-commercial, and within the word limit.
Read the complete guidelines