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The Swiss heroin trials: testing alternative approaches

BMJ 1998; 316 doi: (Published 28 February 1998) Cite this as: BMJ 1998;316:639

Prescribed heroin is likely to have a limited role

  1. Michael Farrell, Senior lecturer,
  2. Wayne Hall, Executive director
  1. National Addiction Centre, Institute of Psychiatry, London SE5 8AF
  2. National Drug and Alcohol Research Centre, Sydney, Australia

    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 …

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