May 29, 2010

Study: Treating Addicts with Heroin is Effective

British researchers said Friday that prescribing heroin to addicts who cannot kick the habit helps them stay off street drugs.

Doctors have had little success in treating the 10 percent or more of heroin users who do not respond to methadone, which is a standard medication to fight the addiction. Users often spiral downward into crime and disease spread by dirty needles and unhealthy living.

Heroin clinics can at least help addicts get off the street.

"What we are dealing with here is a very severe group of heroin addicts, where all of the treatments have been tried and have failed," Dr. John Strang, an addiction expert at King's College London, who led the new study, told Reuters Health.

"They are like oil tankers heading for disaster," he added. "The question we were asking was, 'Can we change the trajectory of these tankers?' And the answer was, 'Yes we can.'"

Strang and his colleagues invited 127 addicts into supervised injecting clinics in order to test how prescription heroin would work for this group. Researchers then randomly chose who would get heroin and who would be injected with methadone.

After six months, 101 addicts had stuck with their treatment. Over two-thirds of those on heroin had no sign of street heroin in their urine at least half the time they were tested. They had been using street heroin almost every day before the study.

Less than a third of the addicts on either type of methadone had a similar number of "clean" tests.

Strang said that at this point, several users have continued in the program for over two years. He told Reuters that some had been able to get jobs and reconnect with their families.

"These sorts of changes are typical of what we are seeing," he told Reuters. "People are not only physically getting better, but they're getting back into society."

The National Institute on Drug Abuse said that about 3.7 million people in the U.S. have used heroin at some point in their lives. Studies suggest that about 200,000 current users spend time in jails each year.

According to experts, methadone decreases cravings for heroin addicts, but it does not produce the same high. This could explain why a substantial number of addicts in treatment backslide.

A handful of other reports had indicated that prescription heroin could help these people. However, the scientific community was not completely convinced because earlier urine tests were not very sophisticated.

"What this study did is that it used a very novel urine test that can differentiate between street heroin and prescription heroin," Thomas Kerr, director of the Urban Health Research Initiative at the University of British Columbia in Vancouver, Canada, told Reuters. Street heroin contains papaverine, a remnant of the opium poppy that can be detected in the urine.

He said, "The evidence is quite clear that there is a place for prescription heroin for the treatment of individuals who do not respond to methadone."

A few European countries already are prescribing heroin to addicts. However, this practice is illegal in the U.S.

Many say that giving addicts more of the substance they abuse makes little sense, and would be like treating and alcoholic with whiskey.

However, Kerr said that analogy was not applicable. 

"I would argue it's completely immoral and unethical to fail to treat those individuals and to allow them to suffer and allow the community around them to suffer," Kerr told Reuters.

Strang said he supported the U.K. Government's 2008 Drug Strategy, which proposes rolling out prescription heroin.

"Now that we know that it works, we have to debate whether or not we should use it," he said.


King's College London