Pubdate: Sun, 19 Oct 2008
Source: Province, The (CN BC)
Copyright: 2008 Canwest Publishing Inc.
Contact: http://www.canada.com/theprovince/letters.html
Website: http://www.canada.com/theprovince/
Details: http://www.mapinc.org/media/476
Author: Cheryl Chan
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)
Bookmark: http://www.mapinc.org/find?136 (Methadone)
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/find?131 (Heroin Maintenance)

NEW TREATMENT WORKS

Painkiller Better Than Methadone Therapy

A legal painkiller called Dilaudid is more effective in treating 
serious heroin addiction than methadone therapy, according to a 
groundbreaking Canadian study.

The North American Opiate Medication Initiative, also known as NAOMI, 
examined the effectiveness of prescription heroin on hard-core 
addicts in Vancouver and Montreal, who have repeatedly failed 
treatment in the past.

Over a 12- to 15-month period beginning March 2007, 115 addicts in 
the study were prescribed medical-grade heroin, while 25 addicts were 
given hydromorphone or Dilaudid in a double-blind study. A control 
group of 111 addicts received oral methadone.

The results, released Friday, showed improved physical and 
psychological health, a decrease in illicit heroin use and a drop in 
criminal activities among all participants.

The retention rate for addicts receiving heroin or Dilaudid was 88 
per cent. All but one of the addicts receiving Dilaudid were not able 
to distinguish it from heroin.

"We were very surprised by what happened with the hydromorphone," 
said lead researcher Dr. Martin Schechter. "We originally thought 
they would figure it out right away, but they didn't." The results 
need to be confirmed in a larger study, but if Dilaudid is equally 
effective as heroin as the study suggests, the ramifications are 
huge, said Schechter.

Because the drug is already legal in Canada, doctors will only need 
approval from the B.C. College of Physicians and Surgeons to use it 
in addiction treatment, he said. "We wouldn't need federal approval 
for it. The legal and political impediments are far less than for 
using heroin." The team, however, will continue to seek approval from 
the feds for heroin as a treatment option, added Schechter.

The NAOMI study also yielded clues on how to improve treatment given 
to methadone users.

It found that an optimized program, which included counselling, a low 
patient-to-staff ratio and a dosage at least 50-per-cent higher than 
what is normally dispensed by pharmacies, retained 54 per cent of its 
patients -- significantly higher than the 40-per-cent retention rate 
of existing methadone programs.

B.C. Health Minister George Abbott said the government is reviewing the study.
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MAP posted-by: Jay Bergstrom