Long-term effects of heroin-assisted treatment in Germany.
OBJECTIVE
Trials in Switzerland, the Netherlands and Spain have found that heroin-assisted treatment (HAT) as maintenance treatment for opioid-dependent patients reduces illicit drug use. A German trial also found diamorphine treatment to be superior to methadone treatment. The present study describes the association between 2 years of heroin treatment and improvements in health and social stabilization, as well as illicit drug use.


METHODS
A prospective cohort study design.


METHODS
A total of 515 patients were assigned to diamorphine treatment; 278 patients remained in the study treatment for the entire period of 24 months (54.8%).


METHODS
The results on physical (Opiate Treatment Index Health Symptoms Scale) and mental (Symptom Checklist 90-Revised Global Severity Index) health and illicit drug use (number of days with drug use within the last month-European Addiction Severity Index) were examined by repeated-measures analyses.


RESULTS
Symptoms of physical (Pillai's trace = 0.837, df = 4, P < 0.001) and mental health (Pillai's trace = 0.450, df = 4, P < 0.001) improved during treatment. Street heroin use declined rapidly (Pillai's trace = 0.836, df = 4, P < 0.001), as did cocaine use (Pillai's trace = 0.280, df = 4, P < 0.001).


CONCLUSIONS
HAT is associated with improvements in mental and physical health in the long term.
Verthein
Uwe
U
Centre for Interdisciplinary Addiction Research of Hamburg University, CIAR, Hamburg, Germany. verthein@sozialwiss.uni-hamburg.de
Bonorden-Kleij
Karin
K
Degkwitz
Peter
P
Dilg
Christoph
C
Köhler
Wilfried K
WK
Passie
Torsten
T
Soyka
Michael
M
Tanger
Sabine
S
Vogel
Mario
M
Haasen
Christian
C
D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D005260:Female; D005858:Germany; D003932:Heroin / Q000627:therapeutic use*; D006556:Heroin Dependence / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D016320:Substance Abuse Treatment Centers / Q000379:methods*; D013995:Time; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D003932:Heroin; D008691:Methadone