Heroin Maintenance

Heroin Assisted Treatment/Heroin Maintenance

Comparison of Client Satisfaction Between Those Treated for Opioid Dependence With Oral Methadone Versus Injectable Heroin

(Comparison of Client Satisfaction Between Those Treated for Opioid Dependence With Oral Methadone Versus Injectable Heroin) "Among long-term chronic opioid injectors participating in a randomized clinical trial prescribing injectable diacetylmorphine or hydromorphone and oral methadone, those receiving injectable medications were more satisfied with treatment. Independent of treatment group, treatment satisfaction was also an indicator of retention in treatment, as well as treatment response, including a reduction in substance use.

Comparison of Client Satisfaction Between Those Treated With Oral Methadone Versus Injectable Heroin

(Comparison of Client Satisfaction Between Those Treated With Oral Methadone Versus Injectable Heroin) "The present study determined participants’ satisfaction with received treatments in the first North American RCT [Randomized Controlled Trial] to provide injectable diacetylmorphine or hydromorphone compared to oral methadone for the treatment of long-term, treatment resistant, opioiddependency.

Effectiveness of Heroin-Assisted Treatment Compared With Methadone Maintenance

(Effectiveness of Heroin-Assisted Treatment Compared With Methadone Maintenance) "Our results on the cost-effectiveness of diacetylmorphine are consistent with those of an economic analysis based on data from two Dutch heroin-assisted treatment trials,21 despite differences in the design of the Dutch trials and the North American Opiate Medication Initiative, and the time horizon and analytic design of the economic analyses.

Proof of Efficacy of Heroin-Assisted Treatment

(Proof of Efficacy of Heroin-Assisted Treatment) "Over the past 15 years, six RCTs [Randomized Controlled Trials] have been conducted involving more than 1,500 patients, and they provide strong evidence, both individually and collectively, in support of the efficacy of treatment with fully supervised self-administered injectable heroin, when compared with oral MMT, for long-term refractory heroin-dependent individuals.

Safe Injection Sites and International Drug Control Treaties

(Safe Injection Sites and International Drug Control Treaties) "23. It might be claimed that this approach [drug injection rooms] is incompatible with the obligations to prevent the abuse of drugs, derived from article 38 of the 1961 Convention and article 20 of the 1971 Convention. It should not be forgotten, however, that the same provisions create an obligation to treat, rehabilitate and reintegrate drug addicts, whose implementation depends largely on the interpretation by the Parties of the terms in question.

Findings from the North American Opiate Medication Initiative

(Findings from the North American Opiate Medication Initiative) "Our study had two primary findings. First, we found that most study participants were motivated for treatment, despite not accessing it in at least the past 6 months (as per trial entry criteria). This may be the result of a lack of accessible or attractive treatment options available to them.

Effectiveness of Heroin-Assisted Treatment

(Effectiveness of Heroin-Assisted Treatment) "Heroin prescription represents a contentious approach to treatment. Many would question whether giving users the drug that they are addicted to constitutes 'treatment' in the normal sense of the word. As with any form of substitution therapy, there is also the question of whether users can be moved on from their drug use – perhaps the fact that users are being prescribed their drug of choice (rather than a frequently unpopular alternative) may mean that users will find it even more difficult to move on to abstinence.

Research Ethics

(Research Ethics) "The most widely accepted document outlining ethical standards for research at the international level is the Declaration of Helsinki [36]. There is a crucial section, paragraph 30, of the document that is pertinent to research on heroin treatment for addiction. It reads:
"'At the conclusion of the study, every patient entered into the study should be assured of access to the best proven prophylactic, diagnostic and therapeutic methods identified by the study'[37]

History of Heroin-Assisted Treatment

(History of Heroin-Assisted Treatment) "The emerging consensus is that heroin is a treatment for a limited number of illicit-drug users who do not do well with other medicines. Historically, however, heroin was the main 'drug of choice' for treatment. In the 1920s and earlier in Britain, it was the treatment or maintenance drug for compliant middle-class addicts, those who accepted the authority of the doctor to prescribe to them.

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