Providing supervised access to medical-grade heroin for heavy users

Providing supervised access to medical-grade heroin for heavy users
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A new RAND corporation study found that providing supervised access medical-grade heroin for heavy users who continue after trying multiple traditional treatments has been successful in some countries.

The study recommends a pilot in the United States of providing supervised access to medical-grade heroin for heavy users who continue to use after other treatment avenues.

Supervising heroin use for heavy users

According to the study, drug consumption rooms or safe injection facilities are places where drug users can consume street drugs they have already purchased using sterile injection supplies. The trained staff are present and will monitor them for overdose or risky injection practices, so that they can intervene if necessary.

Some consumption sites also provide treatment referrals and access to drug testing for the street drugs.

The researchers reviewed the scientific evidence and discussed the effectiveness of supervised consumption sites with two dozen stakeholders in Canada, the Netherlands, Switzerland and the United Kingdom. They also spoke to more than 150 policy professionals, frontline service providers and people who use heroin in New Hampshire and Ohio to examine interest in the two approaches and the perceived barriers.

Piloting the treatment in the US

Heroin cannot legally be prescribed in the US because it is a Schedule I drug.  However, the study states that it would be legal under federal law to conduct randomised controlled trials with the drug. Hydromorphone is classified as a Schedule II drug and is currently prescribed for pain.

Beau Kilmer, the leader of the project and co-director of the RAND Drug Policy Research Center, said: “Given the increasing number of deaths associated with fentanyl and successful use of heroin-assisted treatment abroad, the U.S. should pilot and study this approach in some cities. 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.”

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