Pubdate: Sat, 18 Oct 2008 Source: Globe and Mail (Canada) Copyright: 2008 The Globe and Mail Company Contact: http://www.globeandmail.ca/ Details: http://www.mapinc.org/media/168 Author: Jane Armstrong Bookmark: http://www.mapinc.org/heroin.htm (Heroin) Bookmark: http://www.mapinc.org/find?131 (Heroin Maintenance) Bookmark: http://www.mapinc.org/find?136 (Methadone) PROVIDING SAFE, DAILY DOSES HELPS ADDICTS, STUDY FINDS VANCOUVER -- Most of the hardened heroin addicts who were given free, daily doses of the illegal drug over a 12-month period underwent a positive transformation, committing far fewer crimes while their physical and mental health steadily improved, according to researchers. Addicts also cut their illegal heroin use by 70 per cent, on average, according to researchers from the North American Opiate Medication Initiative. The results of the trial, said Martin Schechter, the project's main investigator, show that hard-core addicts - those with the dimmest chances of recovery - can stabilize their lives when heroin is made free and administered by teams of health-care professionals. "Heroin-assisted therapy is a safe and effective treatment for people with chronic heroin addiction who have not benefited from previous treatment," Dr. Schechter told a news conference in Vancouver. The federally funded clinical trial began three years ago with researchers at Vancouver's University of British Columbia and the University of Montreal scouring both cities for heroin addicts, eventually finding 251 drug users who had previously tried - and failed - to overcome their addictions. Forty-five per cent of the participants received heroin, another 45 per cent received methadone and 10 per cent of the group received hydromorphone, a prescription painkiller. Those who received the hydromorphone - also known as Dilaudid - did not know they were taking the prescription drug, nor did the researchers who administered it. As the program progressed, Dr. Schechter said all but one of the 25 hydromorphone users believed they were taking heroin. The purpose of the hydromorphone study was to see how addicts responded to it. The results have implications for future treatment options, Dr. Schechter said. The study showed that hydromorphone treatment can stabilize heroin users just as well as real heroin. He said jurisdictions that are leery of heroin-assisted drug programs - - for political, legal or ethical reasons - may be more willing to try hydromorphone instead. Researchers have appealed to provincial governments to fund a resumed operation for the clinics, and to immediately allow the use of hydromorphone to treat addicts. The aim of the heroin study was to determine whether a regular and safe supply of heroin could stabilize the lives of addicts, perhaps leaving them in better shape to seek help. The NAOMI study was funded by an $8.1-million research grant from the Canadian Institutes of Health Research. The heroin and hydromorphone participants received three doses a day from health-care professionals in downtown clinics. Most participants - - 192 - were from Vancouver. Fifty-nine were from Montreal. After one year, 90 per cent of the addicts being provided heroin were still in the program and 54 per cent in the methadone program remained - - much higher than the retention rates for conventional treatment, Dr. Schechter said. Researchers said they found a decrease in criminal activity and use of street drugs, and an improvement in health among participants. Participants must have been addicted to heroin for at least five years and attempted treatment twice in the past. "This is a group that society has written off as beyond hope," Dr. Schechter said. He said researchers tried to get participants into other conventional therapies, such as methadone. "Some people do go on to methadone but some do not, and the people who do not relapsed very quickly to back where they were before the study began." Researchers continued to follow participants' progress after the treatment ended, but many have already relapsed, he said. Among the study's other findings: Illicit heroin use dropped 70 per cent among all participants, and the percentage of those involved in illegal activity fell to about 36 per cent from just over 70 per cent. The money participants spent on illegal drugs dropped from an average $1,500 a month to between $300 and $500. The study ended in June, 2008. * Life facts of addiction Demographic characteristics of participants in the Vancouver and Montreal heroin study: (Figures given are percentages.) Age: 39.7 Female: 38.6 First nation: 23.9 Current housing Stable: 27.1 Precarious: 72.9 Generally unemployed in the past three years: 70.9 Received public assistance in the past 30 days: 76.1 Received money through illegal sources in past 30 days: 67.3 Involved in sex work: 17.5 Ever charged for crime: 94 per cent Ever convicted: 81.7 Money spent on drugs in the previous month: $1,500 Days spent in illegal activity in previous month: 15 AVERAGE DRUG USE Days of heroin use in previous 30 days: 26.5 Days of crack cocaine use in prior 30 days: 13.4 Days of speedball use in prior 30 days: 2.7 Number of times injecting drugs in a day: 4.8 Years injecting drugs: 16.5 HEALTH STATUS (figures are percentages) Hepatitis C positive: 62.9 HIV positive: 9.6 Ever attempted suicide: 31.3 Number of previous treatments: 7 Overdoses in life: 4.1 SOURCE: The North American Opiate Medication Initiative - --- MAP posted-by: Larry Seguin