Researchers at the University of Liège in Belgium have been investigating the effectiveness of diacetylmorphine – prescription heroin – for treating severe heroin addiction and keeping these addicts off of street heroin. In a randomized controlled trial involving 74 such patients, the researchers found that daily dosages of prescription heroin administered under medical supervision produced significant improvements in opiate addiction symptoms when compared with addicts in traditional methadone outpatient detox. While the use of prescription heroin to treat severe opiate addiction does have its drawbacks, this could be a realistic treatment approach for the most recalcitrant of heroin users, those who have not found success with Suboxone, injectable naltrexone or methadone.
Prescription Heroin Administered to European Addicts
The use of prescription heroin to treat severe opiate addiction originates in Switzerland, where the compound was developed. The goal of this treatment is to reduce the use of street heroin among the most severely addicted users – it is more of a harm-reduction strategy than a path to abstinence.
Half a dozen randomized controlled trials of this method have been performed in the Netherlands, Switzerland, Germany, Spain, the United Kingdom and Canada, and all have shown that prescription heroin is more effective than methadone outpatient detox for the most severely addicted addicts. In the University of Liège study, the researchers wanted to investigate the feasibility of administering shorter-acting prescription heroin to addicts in the place of longer-acting methadone.
The 74 addicts who participated in the study had all been addicted to opiates for at least five years, although many of them had been struggling with opiate addiction for 10 to 20 years – they were considered long-term addicts. These addicts used street heroin every day, and had already participated in methadone treatment without success at least once on average.
The researchers randomly assigned each addict to receive either inhaled or injected prescription heroin in dosages of 574 mg a day administered up to three times a day, or methadone in dosages of 77 mg a day, for one year. After one year, those who received prescription heroin were switched onto “the best available” treatment for heroin addiction, while those who were on methadone were allowed to continue with this method of outpatient detox if they so chose.
At the beginning the study and at three month intervals throughout the study, the researchers assessed the severity of each addict’s addiction symptoms using several indices of measurement, including the Maudsley Addiction Profile-Health Symptoms Scale, the European Addiction Severity Index, and the Symptom Checklist-90-Revised questionnaire. The researchers also made note of any criminal activity on the part of the study participants during each three-month period, and studied toxicology reports for proof of street drug use.
At the three, six and nine month points during the study, the addicts using prescription heroin for outpatient detox reported significantly more improvement than those using methadone. At each of these three checkpoints, those receiving prescription heroin reported improvements of about 30 percent. By the end of the study, members of the prescription heroin group reported improvements at a rate of about 11 percent, although the researchers don’t feel these results were significant by that point in the study.
Members of the prescription heroin group knew their outpatient detox was about to end, and that may have encouraged regression in the final three months of the study. Ideally, treatment with prescription heroin should have no arbitrary time limit; if administered indefinitely, the researchers believe that the treatment would remain effective.
Could Prescription Heroin for Outpatient Detox Catch On in the U.S.?
Despite the encouraging results of this and other studies, it’s unlikely that prescription heroin for outpatient detox will catch on in the United States. The American government, and people in general, remain skeptical even of the many forms of outpatient opiate treatment already available in the U.S.
In any case, the use of prescription heroin to treat opiate addict may not be ideal for most patients. The drug must be administered up to three times a day to control withdrawal symptoms, which makes its use for outpatient treatment even more inconvenient than that of methadone. Patients on methadone already have trouble living normal lives; that would only be compounded if they were required to visit a clinic or doctor’s office up to three times a day to receive medication. For many American opiate addicts, Suboxone, or a combination of Suboxone and injectable naltrexone, is adequate for outpatient detox. For those who need stronger medication than even methadone treatment alone can provide, American specialists recommend a combination of all three drugs – Suboxone, methadone and injectable naltrexone.
If you are struggling with opiate addiction, Suboxone is today’s treatment of choice. It allows you to keep your privacy intact and live a normal life while being treated for addiction.
Call 888-376-2011 today to learn how Suboxone can help you.