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Effects Of Medical Heroin Co-prescription For Treatment-refractory Chronic Addicts

Quality level: 2

Summary

This study looks at the positive and negative effects of a one year heroin prescription to treatment refractory chronic opiate addicts initially participating unsuccessfully in a methadone programme. This study shows that medical heroin prescription appears to be feasible and safe for treatment refractory chronic opiate addicts.

Type of intervention:
treatment
Sub-area:
pharmacologically assisted treatment
Setting:
Type of approach:
Target group:
adults
Age group:
Annual coverage:
549
Substances addressed:
opiates
Evaluation type:
outcome evaluation, impact evaluation, process evaluation
Country:
Netherlands
Start date:
01/01/1997
End date:
01/02/2002

Overall objective

Determining positive and negative effects of a one-year heroin prescription to treatment refractory chronic opiate addicts initially participating unsuccessfully in a methadone programme. The types of effectiveness measured are psychological, physical, social, public nuisance, judicial contacts and contacts with the drug scene.

Abstract

The Netherlands have an estimated number of 25,000 to 28,000 opiate addicts. After hopeful Swiss experiments with heroin prescription, the Dutch Health Council advised the government in 1995 to study the effects of medical prescription of heroin to treatment-refractory chronic opiate addicts. Free heroin prescription for this subgroup is assumed to decrease the use of other illegal drugs and public related public nuisance. Positive and negative effects are studied of a one-year heroin prescription during to treatment refractory chronic opiate addicts. Measured effects are psychological, physical, social, and public (nuisance or criminality). Effects of prescribed heroin during treatment and after 12 months are compared. The effects of stopping prescription are also evaluated. Is medical heroin prescription (combined with methadone and psychosocial interventions) effective for treatment-refractory chronic addicts? For heroin smokers the overall index score of successful treatment was 23% higher than for the methadone group. Among injecting users this was 25%. Medical heroin prescription also appears to be a feasible and safe (no adverse effects) for chronic treatment-refractory addicts. At this moment a protocol will be constructed to support the choice of prolonged medical prescription for individual addicts who participated in this experiment. Once considered eligible the patient will be reported and controlled by the Health Care Inspectorate.

The PDF contains the full intervention description including additional contact information.

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Page last updated: Friday, 20 January 2012