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STUDY 2014 HTM file
Primary care-based buprenorphine taper vs maintenance therapy for prescription opioid dependence: a randomized clinical trial

Among patients dependent on prescription opioids, ongoing maintenance therapy using a legal opiate substitute (buprenorphine–naloxone) produced better outcomes than tapered withdrawal, with patients less likely to have used illicit opioids and considerably more likely to have remained in their allocated treatment.

STUDY 1999 PDF file 182Kb
Heroin prescribing can help methadone's failures

Studies in UK and Switzerland show that many opiate-dependent patients failed by oral methadone, or seeking treatment but unwilling to give up heroin, do better if prescribed heroin in terms of crime, illicit opiate use and psychological wellbeing.

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.

STUDY 2001 PDF file 107Kb
Injectable methadone maintenance suitable for more severely affected heroin addicts

Conducted in London, the first study to randomise opiate dependent patients to injectable versus oral methadone maintenance suggested that the injectable option is preferable for addicts with relatively severe health and psychological problems.

STUDY 2003 PDF file 235Kb
First large-scale randomised trial boosts case for heroin prescribing

From the Netherlands, the first large-scale, randomised trial found that for patients previously failed by oral methadone, prescribing injectable or smokable heroin instead greatly reduces crime and improves health and social functioning.

REVIEW 2003 PDF file 925Kb
Role Reversal

Controversial, expensive, yet promising so much, interest is increasing in prescribing heroin to heroin addicts. Just five studies hold what answers there are to whether this can work, including a probably unrepeatable early British study.

OFFCUT 2003 PDF file 147Kb
NTA guidance on heroin prescribing

Guidance from the English National Treatment Agency on the prescribing of injectable opioids for the treatment of heroin addiction based on the views of an expert group and a review of the literature.

REVIEW 2009 HTM file
Prescription of heroin for the management of heroin dependence: current status

Should heroin prescribing be a mass treatment entry route or a niche option for the few who have not done well in optimised (but still cheaper) mainstream treatments? With nearly all the latest studies to hand, this review came down firmly on the 'niche' side of the debate.

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.

REVIEW 2012 HTM file
New heroin-assisted treatment: Recent evidence and current practices of supervised injectable heroin treatment in Europe and beyond

Prescribing oral methadone to heroin addicts divides opinions, but prescribing injectable heroin elevates the controversy to another level. Fortunately we now have six randomised clinical trials involving over 1500 patients to ground us in the evidence – and this European Union review to pull it all together.

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