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STUDY 2010 HTM file
Favorable mortality profile of naltrexone implants for opiate addiction
Few treatments for opiate addiction arouse as much controversy as naltrexone implants. Inserted under the skin, these block the effects of heroin for up to several months - for some, a magic bullet, for others, an unsafe and ethically dubious experiment. More evidence from Australia that the overdose death risk is less than with oral forms of the drug.
DOCUMENT 2012 HTM file
Has methadone been rehabilitated?
Arousing visceral opposition and passionate defence, prescribing opiate-type drugs for as long as needed has for decades been the mainstay of heroin addiction treatment in Britain. With the weight of government behind them, that position was challenged by ‘recovery’ advocates; in 2012 an expert report sought to reconcile the competing perspectives.
Concerned that this might on balance cause more deaths by limiting an effective treatment for opiate addiction, an expert panel convened by the US government has changed its mind on whether the risk of a fatal heart attack potentially posed by methadone justifies routine electrocardiogram screening of patients.
Does the small risk of fatal heart attack potentially posed by methadone justify routine electrocardiogram screening of patients, or will this cause more deaths by limiting an effective treatment for opiate addiction? A US clinic tried it and found three at-risk patients in three years.
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.
In the first study of its kind opiate-dependent prisoners in Norway were randomly allocated to a six-month implant which blocks the effects of heroin or to methadone which substitutes for heroin as a way of bridging the period after release. Among the few interested in either option, they led to equivalent reductions in opiate use and crime.
STUDY 2010 HTM file
Treatment research in prison: problems and solutions in a randomized trial
In the first study of its kind, as a way of bridging the period after release opiate-dependent prisoners in Norway were randomly allocated to a six-month implant which blocks the effects of heroin or to methadone which substitutes for heroin. Many prisoners rejected treatment, wrongly believing they would sustain abstinence on release.
In Germany, heroin-addicted patients suffering from mental disorders benefited more from being prescribed heroin than methadone and did so to almost the same degree as other patients, including greater remission in psychiatric symptoms.
Uniquely among modern heroin prescribing trials, the trial in Germany was not confined to heroin-addicted patients who had done poorly on methadone, offering the opportunity to assess whether heroin should be reserved for these patients. The conclusion was that other patients too benefit more from injectable heroin than oral methadone.
STUDY 2010 HTM file
The Andalusian trial on heroin-assisted treatment: a 2 year follow-up
Heroin/cocaine addicts in Granada in Spain who were being prescribed heroin made greater sustained improvements in their illicit heroin use, crime and psychological health and showed signs of more social reintegration than patients who nearly three years before had been randomly allocated to methadone.
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