The DOI matches its Crossref record; 16 of the 16 references it cites were found in a registry or an index.
Medical prescription of heroin to treatment resistant heroin addicts: two randomised controlled trials
Open accessAbstract
Objective To determine whether supervised medical prescription of heroin can successfully treat addicts who do not sufficiently benefit from methadone maintenance treatment. Design Two open label randomised controlled trials. Setting Methadone maintenance programmes in six cities in the Netherlands. Participants 549 heroin addicts. Interventions Inhalable heroin (n = 375) or injectable heroin (n = 174) prescribed over 12 months. Heroin (maximum 1000 mg per day) plus methadone (maximum 150 mg per day) compared with methadone alone (maximum 150 mg per day). Psychosocial treatment was offered throughout. Main outcome measures Dichotomous, multidomain response index, including validated indicators of physical health, mental status, and social functioning. Results Adherence was excellent with 12 month outcome data available for 94% of the randomised participants. With intention to treat analysis, 12 month treatment with heroin plus methadone was significantly more effective than treatment with methadone alone in the trial of inhalable heroin (response rate 49.7% v 26.9%; difference 22.8%, 95% confidence interval 11.0% to 34.6%) and in the trial of injectable heroin (55.5% v 31.2%; difference 24.3%, 9.6% to 39.0%). Discontinuation of the coprescribed heroin resulted in a rapid deterioration in 82% (94/115) of those who responded to the coprescribed heroin. The incidence of serious adverse events was similar across treatment conditions. Conclusions Supervised coprescription of heroin is feasible, more effective, and probably as safe as methadone alone in reducing the many physical, mental, and social problems of treatment resistant heroin addicts.
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Cited by
Strang, J., Volkow, N. D., Degenhardt, L., Hickman, M., Johnson, K., Koob, G. F., Marshall, B. D. L., Tyndall, M., & Walsh, S. L. (2020) · Nature Reviews Disease Primers · doi:10.1038/s41572-019-0137-5 · Cited by 639
Connock, M., Juarez-Garcia, A., Jowett, S., Frew, E., Liu, Z., Taylor, R., Fry-Smith, A., Day, E., Lintzeris, N., Roberts, T., et al. (2007) · Health Technology Assessment · doi:10.3310/hta11090 · Cited by 585
Amato, L., Davoli, M., A.Perucci, C., Ferri, M., Faggiano, F., & P. Mattick, R. (2005) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2005.02.007 · Cited by 567
Retention in medication-assisted treatment for opiate dependence: A systematic review
Timko, C., Schultz, N. R., Cucciare, M. A., Vittorio, L., & Garrison-Diehn, C. (2016) · Journal of Addictive Diseases · doi:10.1080/10550887.2016.1100960 · Cited by 489
Diacetylmorphine versus Methadone for the Treatment of Opioid Addiction
Oviedo-Joekes, E., Brissette, S., Marsh, D. C., Lauzon, P., Guh, D., Anis, A., & Schechter, M. T. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0810635 · Cited by 375
Metadata
- Authors
- van den Brink, W., Hendriks, V. M., Blanken, P., Koeter, M. W. J., van Zwieten, B. J., & van Ree, J. M.
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2003-08-07
- Volume
- 327
- Issue
- 7410
- Pages
- 310
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- OpenAlex
- W1558437381
- Cited by
- 347
- References
- 16
- FWCI
- 25.06
- Type
- journal article
- Language
- en
- Open access
- bronze
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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. https://doi.org/10.1136/bmj.327.7410.310
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