Professor Argues Heroin-Assisted Therapy A Viable, Last-Resort Treatment Option

By McCarton Ackerman 04/17/15

Professor Martin T. Schechter says that those who don't benefit from traditional therapies should be allowed to receive therapeutic heroin.

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Heroin use continues to be a growing problem throughout the U.S. The Centers for Disease Control and Prevention found that heroin-related deaths throughout the country quadrupled between 2000 and 2013, while the National Institute on Drug Abuse reported that the number of Americans who could be classified as heroin dependent doubled between 2002 and 2012, from 214,000 to 467,000.

Statistics like these are why Canadian professor Martin T. Schechter, from the Faculty of Medicine at the University of British Columbia, is arguing that those who have tried and failed conventional treatments for heroin addiction should be allowed to receive heroin-assisted therapy (HAT). His views were published in the latest issue of the British Medical Journal.

HAT is a medically supervised process in which recipients are typically prescribed a synthetic form of heroin called diamorphine and then gradually weaned off it. Numerous studies have found that HAT has been helpful for those who have been unsuccessful with conventional treatments like detoxification and methadone, in addition to contributing to a reduction on illicit drug use, incarceration, and mortality for these patients.

"Conventional therapies such as methadone maintenance should remain the preferred treatment for patients with heroin addiction and should be readily accessible,” he wrote. "But heroin-assisted therapy should be offered to patients who have not benefited from conventional treatments, provided that the diamorphine is prescribed by physicians at specialized clinics that can assure safety."

Although HAT is four times more expensive than traditional treatment options for heroin addiction, the added expenses could more than balance out in the long run. A clinical trial in the Netherlands estimated that HAT would save about $14,100 per patient when compared with methadone therapy. Schechter argued this extra money could then be redirected towards addiction prevention programs.

"The argument that therapeutic heroin is too expensive is false," he said. "Treatments like this represent the holy grail of medical research seeking to support a sustainable health care system: they achieve better outcomes at lower overall cost. The key question is not whether we can afford this new treatment, but whether we can afford the status quo."

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McCarton Ackerman is a freelance writer and editor living in Portland, Oregon. He has been a contributor for The Fix since October 2011, writing on a wide range of topics ranging from medical marijuana in Colorado to the world's sexiest drug smugglers. Follow him on Linkedin and Twitter.