Should Heroin Be Prescribed to Chronic Heroin-Dependent Patients?
Should Heroin Be Prescribed to Chronic Heroin-Dependent Patients?
This is the Medscape Psychiatry Minute. I'm Dr Peter Yellowlees. Several types of medications have been used for stabilizing heroin users, most commonly methadone and buprenorphine, but should heroin itself be prescribed for heroin-dependent individuals? Now 3 investigators from Lisbon, Portugal, have undertaken a systematic review to compare heroin maintenance with methadone or other substitution treatments for opioid dependence. They found a small added value of heroin prescribed alongside flexible doses of methadone for long-term, treatment-refractory opioid users, and this was associated with a reduction in the use of street heroin and other illicit substances and in the probability of being imprisoned, as well as an increase in retention in treatment. The researchers concluded that due to the higher rate of serious adverse events, heroin prescription should remain a treatment of last resort for heroin users. It seems that overall, there is little evidence to support the prescription of heroin to heroin-dependent patients. This article is selected from Medscape Best Evidence. I'm Dr. Peter Yellowlees.
This is the Medscape Psychiatry Minute. I'm Dr Peter Yellowlees. Several types of medications have been used for stabilizing heroin users, most commonly methadone and buprenorphine, but should heroin itself be prescribed for heroin-dependent individuals? Now 3 investigators from Lisbon, Portugal, have undertaken a systematic review to compare heroin maintenance with methadone or other substitution treatments for opioid dependence. They found a small added value of heroin prescribed alongside flexible doses of methadone for long-term, treatment-refractory opioid users, and this was associated with a reduction in the use of street heroin and other illicit substances and in the probability of being imprisoned, as well as an increase in retention in treatment. The researchers concluded that due to the higher rate of serious adverse events, heroin prescription should remain a treatment of last resort for heroin users. It seems that overall, there is little evidence to support the prescription of heroin to heroin-dependent patients. This article is selected from Medscape Best Evidence. I'm Dr. Peter Yellowlees.