Heroin Is More Effective Than Methadone
A new study conducted by researchers at the Providence Health Care and the University of British Columbia proved that treating long-term street heroin users is more cost-effective if the drug used is medically prescribed heroin(diacetylmorphine) rather than methadone.
The study was based on administrative drug data from British Columbia, as well as on the findings drawn from the North American Opiate Medication Initiative (NAOMI) which made a trial of medically prescribed heroin in Vancouver from 2005 to 2008. This was the first clinical trial of prescribed heroin that took place in North America. The treatments were compared using a cost-effectiveness analysis over a periods of one, five and ten-year period, as well as lifetime horizon. The research crew was led by Dr. Aslam Anis, director of the Centre for Health Evaluation and Outcome Sciences (CHÃOS) at Providence Health Care and professor in UBC’s School of Population and Public Health.
Although both medically prescribed heroin and methadone reduce criminal activity, patients treated with heroin stayed in the treatment longer and thus the incidence of relapse was lower in comparison with those treated with methadone and on the long run this means an economic benefit. The study also pointed out that using diacetylmorphine maintenance therapy on a patient makes him more likely to live longer than using methadone.
The average lifetime social costs associated to each therapy are $1.14 million per year per person for the methadone group in comparison to the lesser cost of $1.09 million in the diacetylmethadone group. These numbers were estimated considering treatment expenditures, costs for grug therapies and also costs borne by the justice systems. “NAOMI demonstrated that heroin-assisted therapy is a more effective treatment option than MMT, but now, thanks to this study, we can also confidently say that there are significant economic benefits of using this medication,” explains Dr. Anis .
Co-author Dr. Martin Schechter, a CHÃOS scientist and professor at UBC’s School of Population and Public Health says that the most frequent question on everybody’s mind is whether the direct cost of the diacetylmethadone-assisted theory is too increased to be affordable. “What this study shows is that the more appropriate question is whether we can afford not to,” he adds.
The result of the NAOMI study, based on a randomized trial, was published in the New England Journal of Medicine and it shows that medically prescribed heroin is more cost effective because patients under diacetylmorphine maintenance therapy tent to stay longer in the treatment and thus are more unlikely to use this drug or other illegal drug, and also are more unlikely to be a part of an illegal ativity than patients treated with oral methadone.