Skip Page Header

Home > Heroin maintenance for chronic heroin‐dependent individuals.

Ferri, Marica and Davoli, Marina and Perucci, Carlo A [The Cochrane Library] . (2011) Heroin maintenance for chronic heroin‐dependent individuals. John Wiley & Sons, Ltd. Cochrane Database of Systematic Reviews (12) DOI: 10.1002/14651858.CD003410.pub4

URL: http://onlinelibrary.wiley.com/enhanced/doi/10.100...

Objective: To compare heroin maintenance to methadone or other substitution treatments for opioid dependence regarding: efficacy and acceptability, retaining patients in treatment, reducing the use of illicit substances, and improving health and social functioning.

Drug dependent heroin users are preoccupied with the desire to obtain and take heroin and so have persistent drug-seeking behaviours. Those with a long history of treatment attempts and failures may benefit from the provision of heroin and flexible doses of methadone in a maintenance program. When accepted, this treatment may help them to remain in treatment, limit the use of street drugs, reduce illegal activities and possibly reduce mortality. The authors of the review identified eight randomised studies involving 2007 adult patients with a history of previous treatment failures in outpatient settings.

The heroin users on the programs were requested to attend the clinic to receive and inject prescribed heroin from two to three times a day. Adverse events were consistently more frequent in the heroin groups. The trialists recommend that the treatment should be properly established so that necessary intensive care can be provided in an emergency. According with the current evidence, heroin prescription should be indicated to people who is currently or have previously failed maintenance treatment, and it should be provided in clinical settings where proper follow-up is ensured.


Repository Staff Only: item control page