What's One of the Best Ways to Treat Heroin Addiction? Heroin

Other countries have embarked on heroin maintenance programs and trials, but here in the U.S., ignorance and prejudice still trump science.

It may seem counterintuitive or even nonsensical, but the best way to deal with heroin addiction among some hardcore users may be to give them heroin. That's the takeaway from a seminal study just published by the British Journal of Psychiatry.

The study, "Heroin on trial: systematic review and meta-analysis of randomized trials of diamorphine-prescribing as treatment for refractory heroin addiction," focused on the findings of six randomized controlled trials on supervised injectable heroin treatment in six different countries: Switzerland, the Netherlands, Spain, Germany, Canada, and England.

What the meta-analysis found across all trials was a greater reduction in the use of illicit "street" heroin in patients receiving pharmaceutical heroin compared to the control groups (who generally only received methadone). "Heroin-prescribing, as a part of highly regulated regimen, is a feasible and effective treatment for a particularly difficult-to-treat group of heroin-dependent patients," the study concluded.

It's not just heroin users who benefit. In most of the trials, the researchers found reductions in criminal justice, imprisonment, and health care costs, while finding no negative effects on public safety.

Providing heroin to especially treatment-resistant users is known as heroin-assisted treatment (HAT) or heroin maintenance therapy. While heroin maintenance trials have been underway in several European countries, as well as Australia, and Canada, none have ever been done in the United States.

"The feasibility and effectiveness of heroin-assisted treatment has, once again, been borne out in the scientific literature," said Lindsay LaSalle, a harm reduction attorney with the Drug Policy Alliance. “The question that remains is not whether heroin maintenance is backed by science, but whether it will ever be backed by politicians and government officials in the United Sates.  As of now, the only thing that stands in our way is ideology and stigma."

Nevada became the first state to try to break down the walls preventing heroin maintenance trials when state Sen. Tick Segerblom (D-Las Vegas) introduced a bill that would have created a four-year heroin maintenance pilot project. But that bill didn't pass. 

Phillip Smith is editor of the AlterNet Drug Reporter and author of the Drug War Chronicle.

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