Professor urges heroin assisted treatment over methodone

Prescribing heroin to addicts could be cheaper than methadone, an expert on addiction has suggested.

Professor Martin Schechter, who has long campaigned on the issue, said the drug substitute did not always prove to be effective while heroin treatments have been shown to get people clean as well as reduce harm, lower societal cost and make savings for the healthcare system.

Writing in the BMJ, he said: “Illicit heroin is a dangerous street drug that leads to substantial morbidity and mortality. Because its dose and purity are unknown, users will face the risk of overdose and death.”

Addicts will be in and out of hospitals, court rooms and prisons and “cost society a fortune while suffering immeasurably because they have an illness that society does not like”.

Prof Schechter, of the School of Population and Public Health, Faculty of Medicine at University of British Columbia in Vancouver, Canada, said that while the direct cost of heroin assisted treatment is four times that of traditional treatments, it still works out to be cheaper when accounting for all associated costs compared to other interventions.

He cited six randomised controlled trials that found heroin assisted treatment to be more effective than standard treatments for patients, including one in the Netherlands which estimated that heroin-assisted therapy led to overall savings of about £9,530 per patient a year when compared with methadone, while British researchers found it was more cost-effective than methadone.

“The argument that therapeutic heroin is too expensive is false,” he said.

“Treatments like this represent the holy grail of medical research seeking to support a sustainable healthcare system: they achieve better outcomes at lower overall cost. Those savings could be redirected towards addiction prevention programmes and other priorities.”

He said conventional therapies such as methadone should remain the preferred treatment for patients with heroin addiction, but heroin-assisted therapy should be offered to those who have not benefited from them.

Copyright (c) Press Association Ltd. 2014, All Rights Reserved. Picture (c) Julien Behal/PA Wire.