Characteristics and response to treatment among Aboriginal people receiving heroin-assisted treatment.
BACKGROUND
Medically prescribed diacetylmorphine, the active ingredient of heroin, has been shown to be effective for the treatment of severe opioid addiction. However, there are no data regarding its effectiveness among Aboriginal heroin injectors.


METHODS
The present analyses were performed using data from the NAOMI study (North American Opiate Maintenance Initiative), an open-label randomized controlled trial that compared the effectiveness of injectable diacetylmorphine (45.8%) and hydromorphone (10%) vs. oral methadone (44.2%) among long-term treatment-refractory opioid-dependent individuals. Rates of retention and response to treatment were analyzed among participants from the Vancouver site (n = 192).


RESULTS
Baseline profiles were similar among Aboriginal (n = 60) and non-Aboriginal (n = 132) participants except for higher HIV positive rates among Aboriginal people (23.3% vs. 8.3%). Among Aboriginal participants in the injection and methadone groups, retention rates at 12 months were 84.4% vs. 57.1% and response rates were 68.8% vs. 53.4%, respectively. Aboriginal and non-Aboriginal rates were not significantly different.


CONCLUSIONS
Offering treatment assisted with medically prescribed diacetylmorphine or hydromorphone to long-term treatment-refractory opioid-dependent Aboriginal people could be an effective way to attract them into and retain them in treatment as well as dramatically reduce the risk of HIV infection.
Oviedo-Joekes
Eugenia
E
School of Population and Public Health, University of British Columbia, Vancouver, BC. eugenia@mail.cheos.ubc.ca
Guh
Daphne
D
Marsh
David C
DC
Brissette
Suzanne
S
Nosyk
Bohdan
B
Krausz
Michael
M
Anis
Aslam
A
Christian
Wayne M
WM
Spittal
Patricia
P
Schechter
Martin T
MT
D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D005260:Female; D003932:Heroin / Q000008:administration & dosage; D006556:Heroin Dependence / Q000453:epidemiology / Q000534:rehabilitation*; D006801:Humans; D004091:Hydromorphone / Q000008:administration & dosage; D007198:Indians, North American; D004930:Inuit; D008297:Male; D008691:Methadone / Q000008:administration & dosage; D009294:Narcotics / Q000008:administration & dosage; D016896:Treatment Outcome
D009294:Narcotics; D003932:Heroin; D004091:Hydromorphone; D008691:Methadone