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Feasibility, safety, and efficacy of injectable heroin prescription for refractory opioid addicts: a follow-up study


Rehm, Jürgen; Gschwend, Patrick; Steffen, Thomas; Gutzwiller, Felix; Dobler-Mikola, Anja; Uchtenhagen, Ambros (2001). Feasibility, safety, and efficacy of injectable heroin prescription for refractory opioid addicts: a follow-up study. Lancet, 358:1417-1420.

Abstract

Background:
Heroin-assisted substitution treatment for severely opioid-dependent drug users has been available in Switzerland since 1994. Our aim was to ascertain the feasibility, safety, and efficacy of this treatment.
Methods:
We did a cohort study in 21 community outpatient treatment centres. We assessed 1969 opioid-dependent drug users, who began heroin-assisted substitution treatment between January, 1994, and December, 2000, to ascertain admission and discharge patterns, and patient characteristics. We also followed up a subset of 237 patients who began treatment between Jan 1, 1994, and March 31, 1995, and who stayed with the programme for at least 18 months. We used questionnaires, interviews, and medical examinations done at entry and after 6, 12, and 18 months to assess somatic and mental health, social integration, and treatment outcomes.
Findings:
More than 70% (1378) of patients remained in treatment for more than a year. Treatment showed positive effects with respect to health and social outcomes. A long stay in treatment was related to a higher chance of starting abstinence-oriented therapy than a short stay.
Interpretation:
Heroin-assisted substitution treatment might be an effective option for chronically addicted patients for whom other treatments have failed.

Abstract

Background:
Heroin-assisted substitution treatment for severely opioid-dependent drug users has been available in Switzerland since 1994. Our aim was to ascertain the feasibility, safety, and efficacy of this treatment.
Methods:
We did a cohort study in 21 community outpatient treatment centres. We assessed 1969 opioid-dependent drug users, who began heroin-assisted substitution treatment between January, 1994, and December, 2000, to ascertain admission and discharge patterns, and patient characteristics. We also followed up a subset of 237 patients who began treatment between Jan 1, 1994, and March 31, 1995, and who stayed with the programme for at least 18 months. We used questionnaires, interviews, and medical examinations done at entry and after 6, 12, and 18 months to assess somatic and mental health, social integration, and treatment outcomes.
Findings:
More than 70% (1378) of patients remained in treatment for more than a year. Treatment showed positive effects with respect to health and social outcomes. A long stay in treatment was related to a higher chance of starting abstinence-oriented therapy than a short stay.
Interpretation:
Heroin-assisted substitution treatment might be an effective option for chronically addicted patients for whom other treatments have failed.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
04 Faculty of Medicine > Swiss Research Institute for Public Health and Addiction
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Follow-Up Studies;heroin;opioid;treatment
Language:English, German
Date:2001
Deposited On:04 Jun 2014 08:48
Last Modified:05 Apr 2016 17:47
Publisher:Elsevier
ISSN:0140-6736
Publisher DOI:https://doi.org/10.1016/S0140-6736(01)06529-1
PubMed ID:11705488

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