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Medical Co-Prescription of Heroin: Two Randomized Controlled Trials

NCJ Number
Wim van den Brink; Vincent M. Hendriks; Peter Blanken; Ineke A. Huijsman; Jan M. van Ree
Date Published
180 pages
This study investigated the positive and negative effects of medically prescribing heroin to treatment-resistant heroin addicts.
Based on clinical trails conducted in the Netherlands, this Central Committee on the Treatment of Heron Addicts (CCBH) study focused on the positive and negative effects of prescribing treatment-resistant heroin addicts heroin in combination with methadone. Following a discussion of legally sanctioned and illegal heroin, methadone, and other opiate usage in the Netherlands, this report details the research study design and methods for testing the utility in prescribing heroin in conjunction with methadone to treatment-resistant heroin addicts. Selecting 625 subjects from the local methadone maintenance treatment registration system according to a predefined set of inclusion and exclusion criteria, this study was a multi-center trial of patients located in 8 treatment units, in 6 cities in the Netherlands. In this study, heroin was prescribed to patients in both intravenous injectable and inhaleable form, using two separate protocols. Results from these two trials were statistically analyzed, using two-tailed testing to demonstrate the sample size needed to generate a valid comparison between the two groups. Results of this study indicated that patients benefited from both intravenous and inhalation administrations of heroin when used in conjunction with methadone treatment. After a discussion on the feasibility of heroin prescription, including a presentation on the costs of medical co-prescription of heroin, the CCBH concludes that it is necessary to make available, as a last resort, the prescription of heroin, in the Netherlands, for the treatment of chronic, treatment-resistant heroin addicts who are currently receiving methadone treatments. Tables, figures, references and appendices


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