Heroin Maintenance Treatment In Europe

Heroin addiction is characterized by the incessant need to ingest heroin, a powerful opiate drug, in order to prevent the uncomfortable and often painful withdrawal syndrome from setting in. This condition begins to take affect approximately 6 to 12 hours after the last dose of heroin and causes a vast multitude of symptoms, the most common of which are severe exhaustion, yawning, sneezing, alternating chills and hot flashes, sweating, diarrhea, nausea, vomiting, extreme restlessness, irritability and insomnia.

Heroin withdrawal, often referred to as "dope-sickness" by addicts, is perceived by many to be extremely uncomfortable and, often times, downright painful. It is because of the severity and longevity of opiate withdrawal that even the most determined addicts often have trouble breaking their drug habit. After years of continuous heroin (opiate) abuse, the brain of the dependent individual undergoes radical changes. This is due to the fact that the brain's endorphin system is interrupted and its production of endorphins drastically decreased since it realizes that an exogenous chemical is acting in much of the same way as these naturally synthesized chemicals. Hence, the addict's brain sees production of unneeded endorphins as futile. When heroin use is discontinued for approximately 12 hours or more, the withdrawal syndrome begins to take effect and includes, yawning, tearing, exhaustion, restlessness, insomnia, hot flashes, chills, sweating, diarrhea, vomiting, muscle spasms, and intense craving for more of the drug. Opiate withdrawal is the consequence of not having sufficient endorphin production in the brain, and not having an adequate supply of an exogenous substitute - in this case heroin.

Individuals who exhibit opiate or heroin dependence often have extreme difficulty in weaning themselves off the drug on their own. Therefore, it is usually necessary for the addict to undergo a detoxification process in a professional setting where they have access to medical staff and support medications. If the addict is not successful in this process, he or she may feel it more beneficial to consider maintenance therapy. As most people in today's society are aware, methadone maintenance treatment is probably the most common form of opioid replacement therapy in the world, and by far the most common in the United States (although buprenorphine maintenance is becoming evermore popular). The problem arises when long term opiate habitues refuse to exchange their drug of choice (usually heroin) for another opioid that produces less euphoria like methadone or buprenorphine. In this case, a few progressive countries in Europe have decided that giving addicts legal access to their drug of choice - heroin - in a controlled medical environment is the best solution to promoting harm reduction. They not only believe that it reduces criminal activity, HIV and hepatitis infection, and societal degradation, but their studies have proven so.

Switzerland was the first of several countries in Europe to perform heroin maintenance trials. Due to its findings of reduced crime and HIV infection rates and increased social productivity among the addict population, Switzerland has recently decided to open official, government-run heroin clinics. Since its conception in the mid 1990's, the heroin clinic system has been proven to positively impact the lives of many desperate heroin addicts and their families. The criteria for gaining acceptance into the program are rather strict and include several interviews with doctors and social workers, as well as repeated failed attempts at other maintenance programs including methadone. Now, in 2010, Switzerland has successfully treated several thousands of opioid addicts with heroin. The clinics provide the option of either injecting the drug in solution or ingesting it orally in the form of a pill. Patients must attend at least twice per day for their dosage, and have access to financial, vocational, and pyscho-social counseling resources.

Because of its high success rate, the heroin maintenance program in Switzerland has caught the attention of many other countries in Europe who are currently either conducting their own study with medicinal heroin or already providing a portion of their addict population with heroin (scientifically called diacetylmorphine or diamorphine) as an opioid replacement medication. Holland is one such country (along with Germany, the UK, and more recently Norway).

It has now been officially stated that a second trial will begin in the Canadian cities of Vancouver, Montreal, and Toronto regarding the psycho-social, financial, and health effects of heroin prescribed for opioid addiction and dependence. The first study was modeled after the medicinal heroin studies conducted in Europe and found that heroin maintenance surpassed methadone maintenance in its beneficial effects relating to infection rates, crime, and the overall social status of opioid dependent individuals. A select few were unknowingly given hydromorphone (Dilaudid) instead of heroin, and it was discovered that addicts are often unable to distinguish between the two. This finding has caused the Canadian government and health officials to further investigate the effects of hydromorphone maintenance as compared to heroin maintenance. Hence, a second trial now called SALOME (Study to Assess Longer-Term Opioid Medication Effectiveness) is underway.

When you consider just exactly what the other alternative is to providing these seemingly hopeless addicts with clean, pharmaceutical grade heroin, you begin to realize that the program isn't such a bad idea after all. When accounting for the fact that addicts who have not responded to other methods of treatment such as detox and methadone, refuse to give up their lifestyle of constant drug seeking and consumption, it appears much more practical to give these individuals access to governmental heroin.

You must keep in mind that the addicts who qualify for heroin assisted treatment are the ones who will continue to inject themselves with the unclean, bacteria-ridden heroin solution they purchase and "cook-up" on the street regardless of other available options; that is, except for a purer, cleaner version of the drug. It is the feeling of injected heroin that they are after - not necessarily the unending cycle of crime and illegal activity (which has been proven to drastically decrease after entrance into the program).

Another point to remember is that people who purchase street heroin have absolutely no idea how pure the formulation of the drug may be. Therefore, they are essentially playing "Russian-Roulette" with each shot that is self-administered and are much more likely to suffer from an overdose than those who comply with a heroin maintenance program. When entered into a professional, government regulated clinic with counselors and medical staff who can give them a pure form of the heroin they physically need to function, these addicts can obtain the feeling they seek without the concern of potential overdose.