Addiction, Author Interviews, JAMA, Opiods / 06.04.2016
Injectable Hydromorphone May Be An Alternative Treatment For Chronic Heroin Addiction
MedicalResearch.com Interview with:
Dr. Eugenia Oviedo-Joekes PhD
Assistant Professor, School of Population and Public Health
University British Columbia
Centre for Health Evaluation and Outcome Sciences
Providence Health Care, St Paul’s Hospital, Vancouver
British Columbia, Canada
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Oviedo-Joekes: Diacetylmorphine is the active ingredient in heroin. Medically prescribed diacetylmorphine has shown greater effectiveness than methadone alone for the treatment of patients with long term opioid dependence who are not benefitting from available treatments (i.e., they continue injecting in the street daily for many years). Medically prescribed diacetylmorphine is being used in a small number of countries in Europe but is unlikely to be accepted in many countries around the world, including Canada and the US. SALOME is the world’s first study to examine the effectiveness of hydromorphone, a licensed, legal pain medication, as an alternative treatment to diacetylmorphine for chronic heroin addiction.
Participants were randomly assigned to receive injectable diacetylmorphine or hydromorphone, double-blinded (up to three times daily) for six months under supervision. Injectable hydromorphone was as effective as injectable diacetylmorphine for long-term street opioid users not currently benefitting from available treatments (about 10 per cent of the heroin-dependent population).Study participants on both medications reported far fewer days of street-heroin and other opioid use at six months compared to almost daily illicit opioid use before taking part in the study. They also reported a reduction in days of illegal activities, from an average of 14.1 days per month to fewer than four.
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