Heroin treatment the answer for hardcore opiate addiction?

Following is a piece I recorded on Supervised Injectable Heroin Treatment which airs on the Drug Truth Network's 420 News segment May 6, 2012. The audio file can be downloaded from here.

The federal government and several state Attorneys General are sounding the alarm over heroin use and prescription painkiller addiction. Their approach is more of the same: more law enforcement, more drug testing, and more propaganda. Outside the US, more enlightened approaches are proving effective. The research overall shows substitution treatment with methadone or buprenorphine to be highly effective for those dependent on opiates. Availability of Methadone Maintenance Treatment must be expanded. Still, there are hardcore addicts for whom even methadone fails. What do we do about them? One possible answer: Supervised Injectable Heroin treatment. It's controversial, yet the evidence of its effectiveness in all areas continues to mount. The European Union's drug agency, the European Monitoring Centre on Drugs and Drug Addiction, recently published a review of the literature around heroin treatment. Overall, they concluded: Quote: “Over the past 15 years, six Randomized Controlled Trials have been conducted involving more than 1500 patients, and they provide strong evidence, both individually and collectively, in support of the efficacy of treatment with fully supervised self-administered injectable heroin, when compared with oral Methadone Maintenance Treatment, for long-term refractory heroin-dependent individuals.” End quote. Among other things they found that, quote: “Across the trials, major reductions in the continued use of ‘street’ heroin occurred in those receiving Supervised Injectable Heroin compared with control groups (most often receiving active Methadone Maintenance Treatment).” End quote. And, quote: “Reductions in the criminal activity of Supervised Injectable Heroin patients were evident and were substantially greater when compared with patients under control conditions.” End quote. Most importantly, quote: “Finally, countries that have conducted longer term (up to six years) follow-up studies have seen a high retention in Supervised Injectable Heroin (55 % at two years and 40 % at six years), with patients sustaining gains in reduced ‘street’ heroin use and marked improvements in social functioning (e.g. stable housing, drug-free social contacts and increased rate of employment).” End quote. In the US, where methadone is still considered controversial in some communities and treatment availability is thus quite limited, Supervised Injectable Heroin treatment will seem like a radical approach – yet it works. The question is, how long do we keep doing more of the same, and failing, before we try a different way? For the Drug Truth Network, this is Doug McVay with Common Sense for Drug Policy.