Addiction Treatment: Canadian NAOMI Study Finds Heroin Maintenance Safe, Cheap, Effective

Last Friday, researchers with the North American Opiate Maintenance Initiative (NAOMI) unveiled their long-awaited research results and said they provided new evidence that opiate maintenance for hard-core addicts works and that heroin was more effective than methadone. The results were released only after this month's Canadian federal elections, leading some to charge they had been intentionally suppressed to not hurt the winning Conservatives at the polls.

"Our data show remarkable retention rates and significant improvements in illicit heroin use, illegal activity and health for participants receiving injection assisted therapy, as well as those assigned to optimized methadone maintenance," said Dr. Martin Schechter, NAOMI's principal investigator. "Prior to NAOMI, all of the study participants had not benefited from repeated standard addiction treatments. Society had basically written them off as impossible to treat."

The data traces the outcomes for participants in the three-year project that treated addicts in Vancouver and Montreal. It covers 251 participants.

Some 88% of addicts in "heroin-assisted treatment," or heroin maintenance, stayed in the project after one year, while 54% receiving methadone stayed in. Of particular note, participants being given hydromorphone (Dilaudid) instead of heroin in a double-blind study could not distinguish between the two. According to the researchers, Dilaudid, an opiate licensed for use as a pain reliever, appeared to be equally as effective as heroin, but the study was not designed to test that proposition, and more study is needed.

Illicit heroin use declined by 70%, while the number of participants who reported committing illegal acts declined from 70% to 36%. Similarly, the amount of time spent on illegal activities and money spent on obtaining drugs declined by almost half. In fact, researchers noted that participants who were once spending an average $1,500 on drugs were spending only $300-$500 a month by study's end.

"We now have evidence to show that heroin-assisted therapy is a safe and effective treatment for people with chronic heroin addiction who have not benefited from previous treatments. A combination of optimal therapies -- as delivered in the NAOMI clinics -- can attract those most severely addicted to heroin, keep them in treatment and more importantly, help to improve their social and medical conditions," said Schechter.