title: New aspects in the treatment of heroin dependence with special reference to neurobiological aspects.
abstract: The Swiss trials on medical prescription of injectable diacetylmorphine (pharmaceutical heroin) for "severe" heroin dependence provoked very controversial commentaries. Despite methodological shortcomings, the evaluation of the Swiss heroin trials yielded some interesting findings. Study participants showed substantial improvements in health and well-being and noticeable declines in illicit drug use and criminal activities. Heroin prescription may thus be helpful for some of those who continue to regularly use illicit heroin while maintained on methadone or who refuse other available treatment options. However, research-based evidence suggests that the intravenous (IV) application of heroin under medical supervision may have untoward side effects. Recent studies have shown that heroin injections produce transient, but significant decreases in systemic and cortical oxygenation most likely secondary to respiratory depression. Among others, these effects are the subject of ongoing studies.
authors.affiliation: Department of Psychiatry, University of Basel, Wilhelm Klein-Strasse 27, CH-4025, Basel, Switzerland. dieter.ladewig@pukbasel.ch
authors.forename: Dieter
authors.initials: D
authors.lastname: Ladewig
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Dürsteler-MacFarland
authors.forename: Erich
authors.initials: E
authors.lastname: Seifritz
authors.forename: Christoph
authors.initials: C
authors.lastname: Hock
authors.forename: Rudolf
authors.initials: R
authors.lastname: Stohler
mesh_terms: D000328:Adult; D001921:Brain / Q000378:metabolism*; D018592:Cross-Over Studies; D005260:Female; D006556:Heroin Dependence / Q000188:drug therapy*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008691:Methadone / Q000008:administration & dosage / Q000627:therapeutic use*; D009294:Narcotics / Q000008:administration & dosage / Q000627:therapeutic use*; D010100:Oxygen / Q000378:metabolism*; D016037:Single-Blind Method; D019265:Spectroscopy, Near-Infrared / Q000379:methods
chemical_list: D009294:Narcotics; D010100:Oxygen; D008691:Methadone