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This unique randomised trial tested what would happen if detoxified opiate addicts were then maintained on a substitute drug, on an opiate-blocking medication, or simply counselled. The results led to the introduction of methadone prescribing programmes in Malaysia.
Practice-oriented review of what we know about the diversion (to other people) and misuse (mainly by injecting it) of buprenorphine used in the treatment of opiate dependence, featuring extended, practical guidance on how to identify and respond to these life-threatening behaviours as a therapeutic challenge rather than a disciplinary issue.
STUDY 2000 PDF file 144Kb
Methadone's failures respond to heroin
A large-scale trial in Switzerland suggests that despite failures with other treatments, many long-term heroin addicts respond well to a treatment based on injectable heroin.
REVIEW 2011 HTM file
Heroin maintenance for chronic heroin-dependent individuals
Update of the first authoritative review to combine results from all trials to date of long-term heroin prescribing for the management of heroin addiction finds important advantages for seemingly intractable patients previously failed by methadone, including reduced illegal drug use.
The UK has a long history of prescribing heroin for the treatment of heroin dependence. What has research from six countries concluded about this intensive intervention intended for patients who would otherwise be considered ‘unresponsive’ to treatment?
Slow-release capsules of morphine – the closest drug to heroin – might offer acceptable and effective treatment to addicts who cannot settle on methadone. In England a dozen also being prescribed heroin switched their supplementary methadone to morphine, generally experiencing the benefits they expected and cutting their average dose of heroin.
STUDY 2003 PDF file 164Kb
Naltrexone implants could reduce the early relapse rate after detoxification
Studies from the UK and Germany suggest that subcutaneous implants of naltrexone which block the effects of heroin for up to seven weeks could help reduce the early relapse rate after detoxification more effectively than the oral form of the medication.
STUDY 2004 PDF file 607Kb
Opiate antagonist treatment risks overdose
The most comprehensive recent study of serious medical incidents during and after treatment for opioid dependence highlighted the risk of overdose death when patients stop taking opiate-blocking drugs. In comparison, substitute prescribing was safer even after the patient had left treatment.
STUDY 2006 PDF file 152Kb
Naltrexone implants prevent opiate overdose
Short-acting opiate blockers are associated with high overdose rates when heroin-dependent patients stop taking them. This Australian study suggests that a product intended to block opiates for six months can overcome that problem, though patients may resort to sedatives instead.
STUDY 2006 PDF file 108Kb
1 in a 100 chance of dying after treatment with heroin-blocking drug
In Australia heroin-addicted patients trying to avoid relapse by taking the opiate-blocking drug naltrexone had at least a 1 in a 100 chance of dying within three months, usually from overdose in the weeks after treatment ended; the true figure may have been as high as 8 in a 100.
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