PRESCRIPTION HEROIN ONE HARM REDUCTION OPTION

The Editor,

For a fourth-year nursing school assignment, I researched the use of
prescription heroin in the treatment and harm reduction of heroin
addiction. As of now, methadone is still the only prescription
treatment available in Canada for the treatment of heroin addiction.

Research has repeatedly proven that methadone has a high success rate
in the treatment of heroin addiction. Although there are few side
effects with methadone, it is generally well-tolerated and is often
the treatment of choice for those looking to become addiction free.

But methadone treatment is not for everyone. Research has shown
highly-addicted individuals do not find methadone helpful in the
treatment of their addiction.

A study performed in the Netherlands showed a 51% success rate when
prescription heroin and methadone were used together in treatment
versus methadone alone which only had a 28.4% success rate. Those who
previously underwent treatment with methadone but relapsed did far
better on heroin-assisted treatment with a 61% success rate than on
methadone alone which had a 24% success rate. Individuals who had
never undergone treatment before did nearly equally well with a
combination of prescription heroin and methadone and methadone
treatment alone with 39% and 38% success rates respectively.

For prescription heroin treatment, just like any other medical
treatment, some people are better candidates than others due to their
treatment history and severity of addiction. Prescription heroin may
be a suitable treatment for many but is not for those who have mild
dependencies, short drug use history or have little to no treatment history.

As heroin treatment is more expensive than methadone treatment, it
should be offered only to those who have not or will not find
standard treatment successful. Treatment involving a combination of
both or methadone alone needs to be performed under medical
supervision, with adequate nursing, medical, social and psychological support.

I would like to clarify that, by allowing prescription heroin to be
available for treatment of addiction, heroin would not be available
to the general public. Strict enforcement of illegitimate drug
trafficking, as outlined in the Four Pillars Drug Strategy, would
still need to take place. Well thought-out processes must be employed
to ensure this treatment is not misused and/or abused.

But it is time we looked at alternative treatments and truly
considered the potential of prescription heroin as a harm reduction strategy.

Gurpreet Bains

Port Coquitlam