Using a medically prescribed form of heroin to treat addicts is less costly and more beneficial in the long run than regular methadone therapy, a recent study suggests.
The prescribed form of heroin, known diacetylmorphine, is generally considered more expensive than methadone therapy. But researchers have found that addicts who are given the pricier option stay in treatment longer and are less likely to relapse, and therefore be involved with drug-related criminal activity such as robberies to support a drug habit, leading to long-term savings.
The findings, published in the Canadian Medical Association Journal, hint that heroin-assisted therapy is both medically helpful for patients and an economically-wise choice for society.
Those findings were drawn from the North American Opiate Medication Initiative (NAOMI), a trial that compared the effectiveness of medically-prescribed heroin and methadone therapy in addicts from 2005 to 2008.
To analyze cost-effectiveness, researchers compared the two treatments over a one-, five- and 10-year period, as well as a lifetime projection.
The takeaway was that a person receiving methadone therapy cost society an average of $1.14 million over the course of a lifetime, while those treated with medically-prescribed heroin racked up a lesser cost of $1.09 million.
Those societal costs include the cost of treatment, clinic expenses as well as projected costs carried by the justice system.
"Thanks to this study, we can also confidently say that there are significant economic benefits of using this medication," Dr. Aslam Anis, a leading researcher on the study, said in a statement.
More than 250 participants in Vancouver and Montreal participated in the NAOMI study. Subjects had to have been addicted to heroin for at least five years and twice failed methadone treatment.
"The question I get most about heroin-assisted therapy is whether we can afford the increased direct costs of the treatment," said study co-author Martin Schechter, a scientist with the Centre for Health Evaluation and Outcome Sciences (CHEOS).
"What this study shows is that the more appropriate question is whether we can afford not to," he said in a statement issued Monday.
Methadone, taken orally, assists addicts by blocking receptors in the brain which govern cravings and withdrawal symptoms.
Patients prescribed diacetylmorphine inject the drug in a controlled clinic setting to curb the risk of HIV or hepatitis C infection.
The comparative study is a collaboration between CHEOS, the University of British Columbia, the University of Montreal and the Northern Ontario School of Medicine.
