BMJ 1998;316:639-639 ( 28 February )

Editorials

The Swiss heroin trials: testing alternative approaches

Prescribed heroin is likely to have a limited role

The first 150 words of the full text of this article appear below.

Over half a million heroin misusers receive oral methadone maintenance treatment world-wide1 but the maintenance prescription of injectable opioid drugs, like heroin, remains controversial. In 1992 Switzerland began a large scale evaluation of heroin and other injectable opiate prescribing that eventually involved 1035 misusers. 2 3 The results of the evaluation have recently been reported.4 These show that it was feasible to provide heroin by intravenous injection at a clinic, up to three times a day, for seven days a week. This was done while maintaining good drug control, good order, client safety, and staff morale. Patients were stabilised on 500 to 600 mg heroin daily without evidence of increasing tolerance. Retention in treatment was 89% at six months and 69% at 18 months.4

The self reported use of non-prescribed heroin fell signifianctly, but other drug use was minimally affected. The death rate was 1% per year, and there were no deaths from overdose among participants . . . [Full text of this article]
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Relevant Article

The Swiss heroin trials
G R Venning, Alex Wodak, Wayne Hall, and Michael Farrell
BMJ 1998 317: 1011. [Extract] [Full Text] [PDF]

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  • van den Brink, W., Hendriks, V. M, Blanken, P., Koeter, M. W J, van Zwieten, B. J, van Ree, J. M (2003). Medical prescription of heroin to treatment resistant heroin addicts: two randomised controlled trials. BMJ 327: 310- [Abstract] [Full text]  
  • Keen, J., Oliver, P., Rowse, G., Mathers, N. (2000). Keeping families of heroin addicts together: results of 13 months' intake for community detoxification and rehabilitation at a family centre for drug users. Fam Pract 17: 484-489 [Abstract] [Full text]  
  • Keen, J. (1999). Managing drug misuse in general practice. BMJ 318: 1503-1504 [Full text]  
  • Venning, G R, Wodak, A., Hall, W., Farrell, M. (1998). The Swiss heroin trials. BMJ 317: 1011-1011 [Full text]  
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