Hydromorphone Found To Reduce Heroin Cravings, Study Says

By McCarton Ackerman 04/07/16

Some participants in the study had their drug consumption drop from almost daily to three to five days per month.

Hydromorphone Found To Reduce Heroin Cravings, Study Says
Photo viaVaprotan/Wiki Commons

A groundbreaking study out of Vancouver may offer new hope for chronic heroin users. The four-year study was able to demonstrate, for the first time, the potential for hydromorphone to act as a viable substitution treatment option for chronic heroin addiction.

The findings were published in the latest issue of the Journal of the American Medical Association Psychiatry on Wednesday. The 202 participants in the study had been using street heroin for an average of 15 years and had unsuccessfully attempted to overcome their addictions with methadone maintenance on several occasions in the five years prior to the study.

Participants in the double-blind study either received hydromorphone, a licensed pain medication, or diacetylmorphine, more commonly known as pharmaceutical-grade heroin. However, they didn’t know which of the two substances they were receiving. Hydromorphone is commonly used in palliative care and end-of-life treatments, but had never before been analyzed as an option for treating opioid dependence.

Lead researcher Dr. Eugenia Oviedo-Joekes said to the Globe and Mail that hydromorphone and diacetylmorphine were equally effective in reducing heroin cravings. Participants on both medications had their drug consumption drop from almost daily to three to five days per month. Their illegal activities also declined from an average of 14 per month to less than four a month. Oviedo-Joekes also noted that 80% of the participants finished out the study, which is especially noteworthy because many intravenous drug users don’t consistently access the country’s healthcare system.

“This is a very small group of patients—not more than 10% of everybody on substitution treatment—but they are the ones that are the most vulnerable,” she explained. “They are the ones we have failed over and over with every other treatment.”

The results could be an additional boost to heroin-assisted treatment, a last-resort option for heroin addicts who have failed several times at overcoming their addictions with methadone or buprenorphine. Participants in these programs receive prescription-grade heroin in a supervised medical setting. 

Though past research has demonstrated that diacetylmorphine is an effective maintenance treatment option for opioid dependence, it is not available in many countries—it is prescription heroin, after all. For example, the Globe and Mail notes that in Canada, diacetylmorphine must be imported through a specific pharmaceutical company in Europe. In this case, hydromorphone is the more appealing alternative because it is easily available in Canada. This study, having demonstrated that hydromorphone is just as effective as diacetylmorphine, attempts to explore and add to the list of treatment options for chronic heroin addiction. 

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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.