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Study: Heroin Maintenance Cuts Crime, Improves Health
February 10, 2009

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Research Summary

Heroin addicts enrolled in programs that provide them with the drug for free may commit fewer crimes and be more likely to enroll in addiction treatment programs, according to a new study by researcher Peter Reuter.

The Baltimore Sun reported Feb. 8 that Reuter, a drug-policy researcher at the University of Maryland at College Park, studied heroin-maintenance programs in Switzerland, the Netherlands, Germany, and Vancouver, B.C. Program costs were high, participation low, and outcomes were mixed, Reuter found. But in some cases results were impressive.

In Switzerland, for example, 60 percent of those who left a heroin maintenance program sought addiction treatment, and crime involvement among participants in a German program fell from an average of 15.6 days to 2.5 days at the end of a 12-month period.

The study was funded by Baltimore's Abell Foundation. Reuter said that Baltimore, with its large population of heroin users, might be a good location for a U.S. pilot heroin-maintenance program.

"It is a sensible innovation to consider," he said. "I am not a passionate advocate for it, but I do think someone should try it in the U.S. It has enough plausibility that it's worth trying."

Baltimore officials, however, dismissed the suggestion. "I think it would be a mistake to pursue an expensive and unproven idea when we need more resources for effective drug treatment," said city health commissioner Joshua M. Sharfstein.

"Most studies clearly show they help but using public funds to fund something like this would be a whole other level of politics, especially in this economy," said Christopher Welsh, assistant professor of psychiatry at the University of Maryland medical school.

Peter Beilenson, a former Baltimore health commissioner, added, "The problem is if you are going to do any reasonable drug-policy reform, this heroin thing is such a red flag that it takes all the attention away. It makes it look like anyone who is interested in drug policy reform is crazy."

Former Baltimore Mayor Kurt L. Schmoke once opposed heroin maintenance, but now says that the idea should at least be discussed. "Without the kind of discussion that the Abell Foundation is trying to encourage, it would simply be too shocking to the public to get approved," he said.

COMMENTS ON THIS ARTICLE:

Posted by Kevin Wadalavage on 11 Feb 09 08:17 AM EST
I once read a journal article on the Swiss maintenance program and one of the reasons it seemed successful is that the users were brought together into congregate use areas and service providers were then able to access them and discuss treatment & address MH & medical issues. If we had this approach with all active users, perhaps we would get better results regardless of whether maintenance is offered.

Posted by Allen McQuarrie on 11 Feb 09 09:09 AM EST
We have to demonstrate that funding prevention, treatment and recovery support for D&A results is an economic stimulus especially in hard economic times. No more cuts, supplement 40%-60% recovery rate and stimulate a return on investment our current economy demands.

Posted by Robert J. Chapman, PhD on 11 Feb 09 09:17 AM EST
Having lead student tours to Amsterdam for some years, I have had the opportunity to observe the Dutch heroin maintenance program evolve over time. It would appear that the Dutch have experienced similar benefits from their program to that reported in the article. It has been reported that although patients in the program can receive a max dose of, I believe, 1 gram a day, many not only find work and end criminal activity, but settle in to a maintenance dose of less than that prescribed max. Such individuals are then more easily approached with treatment options, including abstinence-oriented programs.

Posted by clark brittain on 11 Feb 09 09:22 AM EST
before an aggressive american pursuit of the war on drugs (wod) england did maintenance therapy regularly... people could purchase cocaine reefers at the pharmacy with an rx etc... they found that those folks mostly worked, did not pursue criminal endeavors to obtain their drugs, felt better and in general their 'habits' had a longevity of about 10 years...after all drug use is a medical/social issue and should not in any way be a legal issue other than if a non drug crime is committed... and if drugs were readily available crime rates would plummet- recall 1933 and the end of alcohol prohibition...

Posted by Anthony J Fontana C.A.S.A.C on 12 Feb 09 11:11 AM EST
I believe this is both a benefit for society as well as the addict population but of course not without individualized co-treatments.The present economic situation as well as cheap heroin will create crime like that of the recent crack epidemic.The needy as well as the greedy will fuel this fire with hopes of buying stolen items(meats ,baby formula etc) cheaper.Heroin as a medicine will also keep the non-violent out of already crowded jails and a stop to the expensive and non effective "War on Drugs".In addition many crack/cocaine and meth users are switching to heroin.This is a step to protect society as well as treat the non violent addicts.

Posted by Brinna on 12 Feb 09 02:28 PM EST
Clearly, programs which treat people as human beings, with respect, work much better than the punitive, moralistic approach favored by drug warriors.

Posted by Richard on 17 Feb 09 12:32 PM EST
Any program that allows heroin addicts to enter the world of gainful legal employment, civic and family responsibility will--no matter what the up front costs--ultimately save our society both money and heartache.

Posted by Stephen Buchness on 22 Feb 09 01:54 PM EST
It is interesting that the article following this one states "New restrictions will be placed on prescription of two dozen powerful Schedule II narcotic drugs including OxyContin, methadone and morphine." On the one hand we want to believe that individuals will self-correct destructive behavior, while at the same time we act to protect individuals from Rx options

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