- Alex Morgan for DRCNet
On Saturday, June 8, the New York Academy of Medicine hosted the First International Conference on Heroin Maintenance, sponsored by Beth Israel Medical Center, Columbia University School of Public Health, The Lindesmith Center of the Open Society Institute, Montefiore Medical Center, the New York Academy of Medicine and the Yale Center for Inter-Disciplinary Research on Aids.
The conference was the first major presentation in the United States of the results the Swiss research project that has maintained over 1000 addicts on heroin.
In the introduction to the research summary, Ethan Nadelmann, Director of The Lindesmith Center, said, "Oral Methadone works best for hundreds of thousands of heroin addicts but some fare better with other opiate substitutes. In England, doctors prescribe injectable methadone for about 10 percent of recovering patients who may like the modest "rush" upon injection or the ritual of injecting." In various countries oral morphine, codeine and buprenorphine have also been used as maintenance drugs.
Nadelmann noted that, "The Swiss study has undermined several myths about heroin and its habitual users...given relatively unlimited availability, heroin users will voluntarily stabilize or reduce their dosage and some will even choose abstinence; that long addicted users can lead relatively normal, stable lives if provided legal access to their drug of choice..."
Dr. Ambros Uchtenhagen, Principal Investigator of the Swiss National Project on the Medically Controlled Prescription of Narcotics, discussed the results of the three year study, which was conducted at seventeen out patient clinics and one penal institution. The project tracked 1,146 patients from January '94 to December '96, in order to study the effects of prescribed heroin on the health, social integration, and dependent behavior of the research participants.
The Swiss targeted the study at addicts who were doing poorly on methadone maintenance, continuing to use illicit drugs such as heroin, cocaine and benzo-diazepams as well as alcohol. To participate in the study, the addicts had to be at least twenty years old with two years of addiction and a history of failure at other treatment modalities.
No take home heroin was provided and the patients had to come to the clinic to inject under supervision two or three times a day. They were also given counseling and appropriate social services, as needed.
The results were remarkable:
Also at the conference were researchers from the Netherlands, where a heroin maintenance study will begin next month, and Australia, where a study was set to begin a few months ago until the federal government withdrew its consent three weeks before the start date.
One of the main developments of the conference was a meeting held the next day at the Lindesmith Center, where researchers discussed the possibility of a North American heroin maintenance trial with cities in the US and Canada participating. The Baltimore Sun has run several recent stories about the possibility of such a program being set up at the Johns Hopkins University in Baltimore.
We will be posting a more detailed report on the conference over the coming weeks. Much more information on drug maintenance can found on the Lindesmith Center web site, http://www.lindesmith.org.