It helped heroin addicts who had tried and failed to treat their addiction multiple times.
Heroin addiction is notorious for being one of the most difficult addictions to overcome, but researchers from Canada have discovered that a morphine-like drug has the potential to curb the addiction in a safe and effective way.
The researchers focused on people with heroin addiction who had tried and failed to treat their addiction multiple times with existing medications, like methadone and buprenophine, but continue to use street heroin.
Previous research has shown that treating heroin addiction with medical-grade heroin — which contains only the active ingredient in heroin (diacetylmorphine) and none of the other compounds found in street heroin — has proven to be effective in reducing drug use and getting addicts to stick with their treatment.
However, in many countries, including the United States, medical-grade heroin is illegal, so it’s not an option for heroin addicts when they seek treatment.
The Canadian researchers wanted to see if a similar drug, a pain reliever called hydromorphone (which is related to morphine), could work as an effective alternative treatment to medical-grade heroin.
“Hydromorphone had never been evaluated as a substitution treatment for opioid dependence," said principal investigator Dr. Eugenia Oviedo-Joekes in a press release. "Hydromorphone is a widely available licensed pain medication. Our study shows that hydromorphone is as effective as diacetylmorphine, providing a licensed alternative to treat severe opioid use disorder.”
The study, which is published in the Journal of the American Medical Association (JAMA) Psychiatry, involved 200 people who were randomly assigned to take either hydromorphone or medical-grade heroin over a period of six months of treatment.
In both groups, the volunteers reduced their use of heroin by similar amounts, suggesting that the morphine-like drug could be similarly as effective as medical-grade heroin.
At the start of the study, the participants were using street heroin an average of 27 days per month, but at the end of the treatment, the volunteers in the hydromorphone group were using street heroin just five days per month, and those being treated with medical-grade heroin were using it about three days per month.
"As diacetylmorphine is not presently available in many countries for political and/or regulatory reasons, hydromorphone has a significant advantage as a legal, licensed pain medication," said Dr. Patricia Daly, Vancouver Coastal Health's chief medical health officer.
Plus, treatment with hydromorphone was linked with fewer serious side effects, like overdoses and seizures, than treatment with medical-grade heroin — so it could also be the safer choice.
However, both medical-grade heroin and hydromorphone should be considered “last resort” treatments for heroin addicts. Dr. Daly says that methadone and buprenorphine are effective treatments for many heroin addicts and should “remain the first line responses.”
“No single treatment is effective for all individuals,” she adds, and “every person with severe opioid use disorder left untreated is at high risk of serious illness and premature death.”
The study participants had failed at least twice to treat their addictions with other methods, and had been using street heroin for an average of 15 years — so these are the cases that would qualify for these radical “last resort” treatments.
In order to be able to use hydromorphone to treat heroin addictions, there would have to be regulatory changes in the US. Although the drug is approved for pain relief, doctors currently can’t use it to treat people with a heroin addiction since the drug is an opioid and it’s illegal to use any opioids other than methadone and buprenorphine to treat heroin addiction.
Still, the results of the study are exciting because they show that long-term heroin addicts who have tried and failed to treat their addictions could have a new option. With science, there’s always reason to stay hopeful.