Prescribing drug users heroin is more ‘cost-effective’ than methadone, claim scientists
Users prescribed medicated heroin were more likely to stay in treatment or quit altogether than those on methadone
By Claire Bates
PUBLISHED: 10:48, 13 March 2012 | UPDATED: 10:48, 13 March 2012
Medically prescribed heroin is more cost-effective than methadone for treating long-term users, researchers claim.
The controversial study found patients treated with the prescribed heroin were more likely to stay in treatment or quit the drug altogether than patients treated with oral methadone.
They were also more likely to spend less time in relapse and to reduce their use of other illegal drugs, according to the University of British Columbia research.
The study, published today in the Canadian Medical Association Journal, said the results are associated with reduced criminal activity and lower health care costs.
Those in the heroin group were also more likely to live longer than someone receiving methadone maintenance therapy.
The findings were drawn from the North American Opiate Medication Initiative (NAOMI), the first north American trial of medically prescribed heroin, which took place in Vancouver from 2005 to 2008.
The researchers, led by Dr Aslam Anis, used a cost-effectiveness analysis to compare treatments over a one-, five- and 10-year period, as well as a lifetime horizon.
Those in the methadone therapy group generated an average lifetime societal cost of £730,000 ($1.14 million) per person, while those in the diacetylmorphine group generated a lesser cost of £703,000 ($1.09 million).
The study considered treatment expenditures, estimated costs for drug therapies and costs borne by the legal system.
‘NAOMI demonstrated that heroin-assisted therapy is a more effective treatment option than MMT, but now, thanks to this study, we can also confidently say that there are significant economic benefits of using this medication,’ Dr Anis said.
‘The question I get most about heroin-assisted therapy is whether we can afford the increased direct costs of the treatment,’ said co-author Dr Martin Schechter.
‘What this study shows is that the more appropriate question is whether we can afford not to.’
The NAOMI study was a randomised trial aimed at testing whether medically prescribed heroin was more effective than methadone therapy for individuals who were not currently benefiting from conventional treatment.
Heroin is made from morphine and is an extremely strong painkiller that makes users feel warm, sleepy and relaxed. The Class A drug is also highly addictive and causes cravings in the brain. Meanwhile the body builds up a tolerance to it, so increasing doses are needed to get the same ‘high’ or eventually even to feel ‘normal.’
Repeated injections can cause vein damage and blood clots and sharing needles can spread viruses like HIV and Hepatitis C. If taken with alcohol it can potentially cause a user to choke on their own vomit.