Heroin‐assisted treatment as a response to the public health problem of opiate dependence

• Published in: European journal of public health Vol. 12; no. 3; pp. 228 - 234
• Main Authors: Fischer, Benedikt, Rehm, Jürgen, Kirst, Maritt, Casas, Miguel, Hall, Wayne, Krausz, Michael, Metrebian, Nicky, Reggers, Jean, Uchtenhagen, Ambros, Van Den Brink, Wim, Van Ree, Jan M.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.09.2002; Oxford Publishing Limited (England)
• Subjects: Acquired immune deficiency syndrome; AIDS; Australia; Canada; clinical trials; Clinical Trials as Topic; Crime - statistics & numerical data; Drug addiction; Drug therapy; Drug use; Estimates; Europe; Health sciences; Hepatitis B; Heroin; Heroin - adverse effects; Heroin - therapeutic use; heroin‐assisted treatment; HIV; Human immunodeficiency virus; Humans; Market economies; Methadone; Methadone - therapeutic use; Morbidity; Mortality; Narcotics; opiate dependence; opiate pharmacotherapy treatment; Opioid-Related Disorders - drug therapy; Opioid-Related Disorders - rehabilitation; Population; Property crime; Public Health; Substance abuse treatment; Substance Abuse, Intravenous - drug therapy; Substance Abuse, Intravenous - rehabilitation; Australia; Canada; Europe
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/12.3.228

Injection drug use (involving the injection of illicit opiates) poses serious public health problems in many countries. Research has indicated that injection drug users are at higher risk for morbidity in the form of HIV/AIDS and Hepatitis B and C, and drug‐related mortality, as well as increased criminal activity. Methadone maintenance treatment is the most prominent form of pharmacotherapy treatment for illicit opiate dependence in several countries, and its application varies internationally with respect to treatment regulations and delivery modes. In order to effectively treat those patients who have previously been resistant to methadone maintenance treatment, several countries have been studying and/or considering heroin‐assisted treatment as a complementary form of opiate pharmacotherapy treatment. This paper provides an overview of the prevalence of injection drug use and the opiate dependence problem internationally, the current opiate dependence treatment landscape in several countries, and the status of ongoing or planned heroin‐assisted treatment trials in Australia, Canada and certain European countries.