Researchers have found a way to reduce the ill-effects of heroin addiction and to generally keep the addicts out of trouble, but there’s a catch: The solution is to give the addicts injections of a pure form of pharmaceutical heroin twice a day. In a fascinating new study, Canadian researchers found that addicts who received the prescription heroin were more likely to stay in treatment than those given methadone, the commonly prescribed opioid that manages heroin cravings without providing the high. Experts say lengthy treatment is often needed to treat other diseases as well as provide counseling to reverse criminal behavior and otherwise stabilize addicts’ lives and improve the chances that they will stop using heroin [The Wall Street Journal].
The study enrolled 226 heroin addicts who had been using the drug for at least five years, and who had failed to stick with a methadone-treatment program at least once. Half the subjects came to the clinic to receive shots of diacetylmorphine—pure heroin—while the other half received standard methadone treatment. After one year, 88% of those in the diacetylmorphine group were still in treatment, compared with 54% in the methadone group [Los Angeles Times]. The test subjects who received heroin were also more likely to reduce their criminal behavior and their drug use outside the clinic, according to the study published in the New England Journal of Medicine.
The study did report some serious “adverse events,” which is little surprise when dealing with dangerous drugs and a population that doesn’t always comply with the doctor’s orders. One patient from the methadone group died of an opioid overdose during the 12-month trial. But overall, serious adverse events were more than 2½ times more common among the [diacetylmorphine] group. Sixteen of those participants experienced a life-threatening seizure or overdose; all received prompt treatment at their clinic and recovered [Los Angeles Times]. In almost all those cases, the patients later admitted that they had used other substances.
The idea of distributing heroin to addicts remains extremely controversial, but in parts of Europe and Canada policy-makers have gently proposed harm reduction. The idea is that, even if people can’t get clean, they could still get help to live healthier and more productive lives, avoiding some of the worst health risks of heroin – like HIV and hepatitis C, which are both spread through dirty needles – and eliminating a major reason for crimes like theft and prostitution, used to fund drug habits [Time]. But in the United States, where heroin is classified as an illegal drug with no medical uses, such policies are very unlikely to take hold. In fact, U.S. researchers who had hoped to help with the Canadian study had to drop out because they couldn’t get approval from the U.S. Drug Enforcement Agency and the Food and Drug Administration.
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Image: flickr / Todd Huffman
August 20th, 2009 at 2:40 pm
Legally giving people drugs has consistently failed in helping people overcome addiction. Replacing one drug for another is not treatment and there are many successful programs that don’t use medications in treatment. I would be curious to know who funded the study mentioned in this article. Harm minimization assumes that drug addiction cannot be overcome. That false premise has resulted in more harm than good.
August 20th, 2009 at 4:52 pm
Wasn’t this done in Manchester back in the 1970s with great effect?
August 20th, 2009 at 6:02 pm
So someone has positive results stabilizing the lives of heroin addicts and the “Sigals” of the world say “No!” Sigal, you make the comment that “there are many successful programs”. Give us some statistics. How “successful” are these programs? What percentage of heroin addicts are drug free after 5 years in these programs that you fail to identify. The bottom line is that all drugs – just like nicotine and alcohol – should be legal and controlled by government. In a country like the United States of America, where the individual is king, it seems ludicrous to me that the governemnt interferes in lifestyle choices and then makes criminals of people for making those choices. Help, don’t destroy.
August 20th, 2009 at 6:38 pm
Harm reduction works. So it stands to reason that it’ll never fly in the good ol’ U.S. of A. In America these days, only dumb policies like “The War on Drugs (TM)” are allowed.
August 20th, 2009 at 9:06 pm
My opinion is that this is a hard problem. No one solution is going to satisfy everyone, ever.
When I look at addiction at the societal level, the striking thing is that it stubbornly persists, no matter what we do about it. Ban the drugs, make it illegal, have education programs, make addicts pariahs. Some do it anyway.
The thing I am concerned about is that addicts can be a major entry point for disease into the general (non-addict) population. Oh, and crime is ramant in the areas addicts frequent, and that affects us all too. One big step up the criminal enterprise, drug peddling attracts organized crime like flies to honey.
August 21st, 2009 at 2:37 pm
Conservatives that bemoan socialism have no qualms about putting almost 2 million people through our legal system in America, funded by our taxes. We have to look at facts, not be led by our fears. “Just say no” was a huge failure, yet pundits still call it a success. Treatment costs less, and is more effective than incarceration when dealing with drug abusers.
Also, if the punishment should fit the crime, what do you do to deserve getting thrown into Californias illegally overcrowded prison system? A federal review panel said there is no way to prevent or monitor assaults, including rape. Atrocious health care, no where to sleep, and no treatment given. No wonder recidivism is over 70% in some populations.
August 23rd, 2009 at 7:15 pm
What would happen if ALL recreational chemicals were made legal? I suspect (but don’t know) that the relatively small % of drug addicts at any one time would remain about the same,then free choice becomes an actual reality – which is what various societies and govenments have been banging on about.
August 24th, 2009 at 8:29 pm
I have never tried heroin nor have I ever supported anyone that has. I have had more than my share of chaotic tramatic experiences within the last several years. I know what is what in this world, and I know how I need to live to be happy. However, there are a great number of people that will not allow me to live how and where I need to live. All my money making abilities have been shot down everytime I try. I have gotten to the point of hating people that will not help me. I went from owning my own home free and clear at a young age to complete poverty raising two children on 400 dollars per month. I don’t believe in free rides, and therefore I don’t believe in any government enitity that wants to give someone something for nothing.
I suffered a near fatal vehicle accident about 10 years ago, I had multiple head trauma and a broken back in 5 places. I can still walk and I am more intelligent than I ever was, but I still cannot get out of this financial situation which has caused me to hate some members of my family and most of the people I used to have strong relationships with.
I remember the near fatal vehicle accident vividly, the only way I do not dream is when i take sleeping pills.
I don’t want my memory erased because of fear of anything, I want my memory erased because of the extreme hatred I have for human beings as a result of all that has happened to me in the past 10 years. I think if my memory were completely wiped out, I could do the 9-5 jobs that regular people do without complaint and get on with my life. If I do not find a doctor that will fill me a life long perscription for this memory erasing drug, I am almost certain I could kill the person responsible for putting me and my two children into this terrible situation.
Please e-mail a list of doctors near Chambersburg PA that will prescribe me this drug as soon as possible, I do not want to end up in jail because someone was really stupid and messed up my life without a reason.
Thank you
August 27th, 2009 at 10:35 am
> Legally giving people drugs has consistently failed in helping people overcome addiction.
False.
> Replacing one drug for another is not treatment
False.
> and there are many successful programs that don’t use medications in treatment.
True.
> I would be curious to know who funded the study mentioned in this article.
The Canadian Institutes of Health Research.
> Harm minimization assumes that drug addiction cannot be overcome.
False.
> That false premise has resulted in more harm than good.
False.
Sigal, this is a science blog. We prefer finding solutions to ignorance here.
September 3rd, 2009 at 11:38 am
Sigal… “Harm minimization assumes that drug addiction cannot be overcome.” I don’t believe harm reduction programs assume that drug addiction cannot be overcome, but the statistics prove that 90% of people will fail at abstinence when dealing with opioid addiction. I think there is huge disconnect in the addiction field because many of the clinical staff are in recovery and they countertransfer all of their beliefs and ideals onto clients and disregard medical facts and this usually results in conflict with staff. You have to ask yourself if someone can get their family, job, and other areas in their life on track with the use of medication… why not. We have to move forward instead of seeing people come into treatment, fill them with aa/na and expect them to succeed. We have other tools that should be combined with traditional therapies. To improve function and quality of life is the root of all medical therapies not to mention the practice of general medicine is harm reduction and if addiction is a disease, it should be treated as one.
September 3rd, 2009 at 4:31 pm
I am a heroin addict. I was a classical mathematics major at a northeastern state university specializing in encryption theory until i lost everything to my addiction. Because of my felony record (all non-violent drug offences) i will probably never have any kind of meaningful career. I have been through almost every treatment from aa to maintenance programs. I just lost my job in telemarketing for a failed drug test although i don’t go to work high. If this is a disease why shouldn’t we medicate patients legally just like we do for diabetic?
September 23rd, 2009 at 4:26 pm
Having heroin addicts taking heroin to live ‘normal lives’ is ludicrus. I am a heroin addict, I’ve been clean for a little over 9 months. The only way to live a healthy normal life is to go to detox and go on suboxone. It’s worked for me and many other addicts as well. Substitution from one drug to another does not work.
October 8th, 2009 at 4:45 am
Courtney, going on suboxone is substitution from one drug to another…and it works. I’m a heroin addict currently on suboxone maintenance and have been for 5 months. I haven’t used heroin once since i began the treatment. The suboxone does work well but i still have terrible cravings. The cravings are sometimes so overwhelming but i haven’t given in and i don’t plan on ever doing so. If i could have just gotten a perscription to heroin…that would be great. You can live a productive life taking a drug everyday, if you have a legal steady supply, that is. The thing that tears peoples lives apart when it comes to heroin addiction is the fact that it is expensive and illegal. You will go broke/go to jail eventually. Once you have become addicted to opiods, you will always crave the drug. its absolutly terrible and a horrible thing to have to live with. It disgusts me that governments throw addicts in jail for simple drug possession. People don’t realize that opiod dependence is a disease, and it’s one that never goes away. You can relapse any time. When i was in rehab i met a guy who had been clean for 17 years and relapsed. He was a normal, productive person with a wife and kids. If there was a program where he could just get a perscription for his drug, his life wouldn’t have ended up screwed up like it was when he entered treatment. It’s hard for people who have never done drugs to understand. Most people are very ignorant about the whole thing and they act like people who are addicted to drugs are just stupid and should be able to just stop so easily because they don’t understand what it is like. You can’t understand what it’s like unless you have gone through it yourself. After becoming addicted to heroin every time i have gotten clean i have felt like something was missing. You feel like you are not whole. It is hard to explain but it is true. A large amount of people who get addicted to heroin can never successfully quit. This leads to terrible amounts of despair and heartbreak in their lives…it’s really terrible that people have to go through such hell…if the drug was just legal, or if an addict could just be perscribed, this would not happen. Unfortunatly ignorance is very rampant in America, so I’m sure no useful action will ever be taken to correct this problem. Drug rehab programs are EXTREMELY unsuccessful. 9/10 people who go to rehab start usings again, so there goes your argument sigal. You are exactly the ignorant person i am talking about. Legally giving people drugs has consistently failed? Do you have any data to back that up? No….because there isn’t any. If people could legally get drugs the numbers for people infected with hepatitis C would be more than cut IN HALF! and AIDS would probably be greatly reduced. I could keep going on, but it’s late, and I’m going to bed.