A study by the RAND corporation has recommended that a drug addiction treatment involving supervised provision of medical-grade heroin to addicted individuals who have suffered multiple relapses should be piloted and studied in the United States (US). RAND has referred to this approach as heroin-assisted treatment (HAT).
While researchers say increasing access to traditionally approved cessation assistance medication like methadone and buprenorphine should be the top priority, the severity of the opioid crisis in the US makes evaluating all available tools a necessity.
“This is not a silver bullet or first-line treatment. But there is evidence that it helps stabilize the lives of some people who use heroin,” said Beau Kilmer, leader of the project and co-director of the RAND Drug Policy Research Center.
Researchers found the method was far more effective than treatments using only methadone. Most notably, it was far more effective at curbing criminal activity.
Researchers spoke to over two dozen stakeholders in Canada, the Netherlands, Switzerland and the United Kingdom to learn about their experience with this approach. They also consulted 150 policy professionals, frontline service providers and addicts from the American states of New Hampshire and Ohio, both of which have been hit hard by the opioid addiction epidemic in the US.
HAT would utilize supervised consumption sites. These are places where individuals can consume already-purchased street drugs using sterile injection supplies in the presence of trained staff who monitor for overdose or risky injection practices, intervening when necessary. They could also provide other services like referrals to treatment.
In 2013, the United Nations Office of Drugs and Crime (UNODC) estimated that there were 6.7 million drug users in Pakistan, out of which 800,000 Pakistanis aged between 15 and 64 are regular heroin users. The country’s proximity to Afghanistan — which produces the vast majority of the world’s illegal opioids — seems to be a significant factor. Al Jazeera reported in 2014 that 44 tonnes of heroin are consumed in Pakistan every year.