NEW TREATMENT WORKS

Painkiller Better Than Methadone Therapy

A legal painkiller called Dilaudid is more effective in treating
serious heroin addiction than methadone therapy, according to a
groundbreaking Canadian study.

The North American Opiate Medication Initiative, also known as NAOMI,
examined the effectiveness of prescription heroin on hard-core
addicts in Vancouver and Montreal, who have repeatedly failed
treatment in the past.

Over a 12- to 15-month period beginning March 2007, 115 addicts in
the study were prescribed medical-grade heroin, while 25 addicts were
given hydromorphone or Dilaudid in a double-blind study. A control
group of 111 addicts received oral methadone.

The results, released Friday, showed improved physical and
psychological health, a decrease in illicit heroin use and a drop in
criminal activities among all participants.

The retention rate for addicts receiving heroin or Dilaudid was 88
per cent. All but one of the addicts receiving Dilaudid were not able
to distinguish it from heroin.

"We were very surprised by what happened with the hydromorphone,"
said lead researcher Dr. Martin Schechter. "We originally thought
they would figure it out right away, but they didn't." The results
need to be confirmed in a larger study, but if Dilaudid is equally
effective as heroin as the study suggests, the ramifications are
huge, said Schechter.

Because the drug is already legal in Canada, doctors will only need
approval from the B.C. College of Physicians and Surgeons to use it
in addiction treatment, he said. "We wouldn't need federal approval
for it. The legal and political impediments are far less than for
using heroin." The team, however, will continue to seek approval from
the feds for heroin as a treatment option, added Schechter.

The NAOMI study also yielded clues on how to improve treatment given
to methadone users.

It found that an optimized program, which included counselling, a low
patient-to-staff ratio and a dosage at least 50-per-cent higher than
what is normally dispensed by pharmacies, retained 54 per cent of its
patients -- significantly higher than the 40-per-cent retention rate
of existing methadone programs.

B.C. Health Minister George Abbott said the government is reviewing the study.