Handing Out Heroin to Addicts
A hot debate happening in medical circles these days is this: should they give heroin to heroin addicts who are difficult to treat? The British Medical Journal (BMJ) offers arguments on both of sides of the fence.
On the “yes,” side there’s Jurgen Rehm from the Centre for Addiction and Mental Health in Toronto and Benedikt Fischer from the University of Victoria in British Columbia. Their argument that different circumstances call for different measures and that in some cases, heroin may be an appropriate treatment for heroin addicts. The idea is that it’s cost-effective compared to methadone maintenance and has been carried out with positive results in different parts of Western Europe with addicts who were resistant to treatment. Apparently, it’s an option in the UK but the practice is hotly debated.
On the “no” side is Neil McKeganey, a Professor of Drug Misuse Research at the University of Glasgow. He says that the evidence for the efficacy of the treatment are inconclusive and that the mortality of addicts on the treatment as compared to other programs is low. He feels that treatment programs should strive to diminish an addict’s use of heroin rather than just help them maintain a regular habit. It goes beyond harm reduction, or should, in his opinion.
I’m not usually one to take the conservative view, but in cases like these, but in this situation, I find myself solidly on the “no” side. Not necessarily for the reasons put forth by BMJ’s columnist but more for the fact that you still have to cook it, you still have to inject it. It’s feeding both the physical addiction and the mental addiction and, to me, that’s not much of a treatment, even if it does reduce the harm of buying drugs on the street and possibly overdosing.
For more on both sides of the argument, check out “Should heroin be prescribed to heroin misusers? Yes” by Jürgen Rehm, Benedikt Fischer and “Should heroin be prescribed to heroin misusers? No” by Neil McKeganey.
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