News Release

New treatment option for heroin addiction

NB. Please note that if you are outside North America, the embargo for LANCET press material is 0001 hours UK Time 21 February 2003.

Peer-Reviewed Publication

The Lancet_DELETED

An alternative drug therapy to methadone for the treatment of heroin addiction is proposed by Swedish authors of a study in this week's issue of THE LANCET.

Methadone is an established treatment for heroin addiction-however it is usually only given to long-term addicts as there are concerns that it is addictive. Buprenorphine has been suggested for the treatment of heroin dependence, but little research has justified its effectiveness.

Markus Heilig from the Karolinska Institute, Stockholm, Sweden, and colleagues assessed the 1-year efficacy of buprenorphine in combination with intensive psychosocial therapy for treatment of heroin addiction. 40 adults who had been categorised as opiate dependent for at least a year (but who did not meet the Swedish criteria for methadone treatment) were randomly allocated either to daily buprenorphine or a 6-day regimen of buprenorphine followed by placebo.

In addition to treatment allocation, all patients participated in cognitive-behavioural group therapy to prevent relapse, received weekly individual counselling sessions, and submitted regular urine samples for analysis to detect illicit drug use.

The results were striking-three-quarters of those given buprenorphine remained in the treatment programme one year later compared with none of those given placebo. Urine samples were 75% free of opiates or other drugs among those given buprenorphine-suggesting that treatment was effective in reducing heroin and other drug use. The incidence of criminal activity was also reduced among these individuals compared with those given placebo.

Markus Heilig comments: "We believe that our strategy of a highly planned delivery of buprenorphine in combination with cognitive behavioural treatment, seems to offer a useful complement to methadone maintenance treatment, and should be added to treatment options for heroin dependent individuals."

In an accompanying Commentary (p 634), Fergus Law and David Nutt from the University of Bristol, UK, state: "This trial is likely to become a classic in the area. The results have far-reaching implications for the treatment of opioid dependence in general, and the role of psychological treatments and buprenorphine in particular."

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Contact: Professor Markus Heilig, NEUROTEC, Karolinska Institute, M57 Huddinge University Hospital, S-141 86 Stockholm, Sweden; T)+46 8 58586564; F)+46 8 58585785; E) Markus.heilig@neurotec.ki.se

Dr Fergus Law, Psychopharmacology Unit, University of Bristol, School of Medical Sciences, Bristol BS8 1TD, UK; T) +44 (0)117 925 3066; F) +44 (0)117 927 7057 E) Fergus.Law@bristol.ac.uk


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