Evaluation of Heroin Maintenance in Controlled Trial

Addiction, Autonomy, and Informed Consent: On and Off the Garden Path

“…A number of research trials have compared giving treatment-resistant addicts daily heroin (usually self-administered within a clinical setting) with oral and injectable methadone (Hartnoll et al, 1980;Perneger et al, 1998;van den Brink et al, 2003;Haasen et al, 2007;Oviedo-Joekes et al, 2009). The trials indicate that provision of heroin produces benefits for users and for the wider society: improvements in mental and physical health and a decrease in street crime in the patients provided with heroin, compared with those provided with oral or injectable methadone.…”

Heroin Prescription and History

“…The switch from abstinence from illicitdrug use as the only legal option to the use of methadone took place under the influence of re-searchers Dole and Nyswander in New York. 8 In the United States, methadone was associated with the ethos of a "medical" drug, whereas heroin was not. 8 In the United Kingdom in the 1970s, the change came from prescribing heroin to prescribing methadone.…”

“…8 In the United States, methadone was associated with the ethos of a "medical" drug, whereas heroin was not. 8 In the United Kingdom in the 1970s, the change came from prescribing heroin to prescribing methadone. That switch was also legitimated by a trial carried out by researchers Mitcheson and Hartnoll in the drug-dependence unit at London's University College Hospital.…”

What works in drug addiction?

“…Parenteral methadone is also available, with licensing not required. Hartnoll et al (1980) reported a 12-month follow-up trial of intravenous heroin v. oral methadone on 96 heroin-addicted individuals in London. Those on heroin maintenance were twice as likely to remain in treatment (74% v. 29%).…”