Medical Health Care Centre

As an alternative to classical detoxification or treatment with oral methadone, the latest research opens a new door of hope to the 5% -10% of heroin addicts who fail in their attempt to overcome their dependence. This is replaced by diacetylmorphine oral methadone, the active ingredient of heroin intravenously. So I proposed an article published in the journal The Lancet.

In order to compare results, several specialists of the Institute of Psychiatry, Kings College London (United Kingdom) recruited a selected group of chronically ill heroin addicts: those who had received oral methadone treatment since at least 26 weeks and yet continued to inject heroin in the street with some regularity (50% of the time of the trial, ie 13 weeks).

In total, 127 people. Of these, 42 began to be treated with injected methadone (not used in Spain) /, 43 with heroin (diacetylmorphine) injected and oral methadone 42. All were subjected to the method that had been assigned for a period of 26 weeks. After this time, the researchers found positive results in all cases, especially among patients with heroin injection, as adherence to treatment was 88%. This percentage was reduced to 81% in the group injected methadone and 69% among those receiving oral methadone.

According to British research shows, patients treated with injected heroin were the most reduced in the street shots (66%), followed by injection of methadone (30%) and oral methadone (19%).

These findings are consistent with other previous investigations, one conducted in Spain and directed by Joan Carles March, a professor at the Andalusia School of Public Health. The difference is that the new paper introduces injected methadone to compare their effects, and also works with other patients. “We chose people who had failed at least two treatments, injecting most days and met two of these three requirements: they had a disease (HIV, hepatitis …), mental health problems (dual diagnosis) and family-law type. In short, they were people with more severe dependence, with a much harder and more excluded, “the Spanish researchers.

In any of the studies, the aim of the experts is that the injected heroin used as a second treatment of choice for those who do not respond to other treatments (the first is oral methadone). “We have shown that injected heroin injections significantly reduced in the street and comparing it with the other two options, the difference begins to show at six weeks,” British researchers say.

The problem, as Thomas says Kerr of the University of British Columbia (Vancouver) in an accompanying editorial, is that “history has shown that prescribing heroin injection as a treatment not only depends on the tests to confirm its effectiveness and safety, but political interests.” Do not forget that this issue is surrounded by controversy, as many are opposed to the idea of making ‘no more’ a substance that is illegal.

Precisely for this reason, Joan Carles March plans to launch a new investigation to compare the effects of three treatments: oral morphine, methadone and heroin oral. “Given that, unlike morphine, heroin is illegal in Spain, if we conclude that morphine provides similar results, then no need to legalize heroin.” In any event, the researcher, our initial hypothesis is that “heroin can be better than oral morphine and oral methadone heroin in Dar [...] pills is easier and cheaper. Does not require that the patient will before measuring their constant nor do you need 20 minutes of rest after the injection.”

Currently, in Spain, this option is only available in Grenada. In view of the successful trial of Joan Carles March, it got permission from the Spanish Agency of Medicines to prescribe diacetylmorphine as a drug for compassionate use study to those wishing to continue therapy.