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A Procedure to Study the Effect of Prolonged Food Restriction on Heroin Seeking in Abstinent Rats
Published on: November 11, 2013
Heroin maintenance for chronic heroin-dependent individuals
Marica Ferri1, Marina Davoli, Carlo A Perucci
1Scientific analyst Best practice, Interventions, laws and policies unit, EMCDDA, Cais do Sodre' 1249-289 Lisbon, Lisbon, Portugal.
The Cochrane Database of Systematic Reviews
|August 6, 2010
Summary
Heroin maintenance treatment, when combined with methadone, shows potential benefits for long-term opioid users who have not responded to other treatments. However, increased adverse events mean it should be a last resort option.
Area of Science:
- Pharmacology
- Addiction Medicine
- Clinical Trials
Background:
- Opioid dependence is a significant public health issue.
- Methadone, buprenorphine, and LAAM are established substitution treatments.
- Heroin prescription is an alternative treatment approach for specific patient groups.
Purpose of the Study:
- To compare heroin maintenance with methadone or other substitution treatments.
- To evaluate efficacy, patient retention, illicit substance use, and health/social functioning.
- To assess heroin prescription as a treatment for opioid dependence.
Main Methods:
- Systematic review of randomized controlled trials.
- Searched Cochrane, MEDLINE, EMBASE, and CINAHL databases.
- Included trials comparing heroin maintenance (alone or with methadone) to other pharmacological treatments.
Main Results:
- Heroin maintenance showed a marginal benefit in patient retention.
- Combined heroin and methadone treatment reduced illicit substance use and incarceration rates.
- Adverse events were more frequent in the heroin group; no significant difference in mortality.
Conclusions:
- Heroin prescribed with methadone offers a small added benefit for treatment-refractory opioid users.
- It can decrease illicit substance use and imprisonment, and improve treatment retention.
- Due to higher adverse events, heroin prescription should be a last resort treatment.
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