Heroin addiction is steadily increasing in the United States. Likely a byproduct of the painkiller abuse and addiction epidemic that was at its height in recent years, families and the medical community alike are actively searching out the best possible treatment options to help those in need to safely stop using the drug right away and to stay drug-free for the long-term.
One possibility is the prescription of diacetylmorphine hydrochloride. The active ingredient in heroin, many refer to it as “medical-grade heroin.” Currently, one clinic in Canada has found some measure of success in using it to help people overcome heroin addiction, according to The New York Times.
But is it a viable option for heroin addiction treatment? What are the risks? Is the substance any more or less effective than current medications more widely used (e.g., methadone, buprenorphine)? Should the US consider the possibility of adopting this treatment option? If so, what populations would most benefit from its use, and would any be harmed by it?
One of the initial red flags that arises when considering the use of diacetylmorphine hydrochloride as a treatment option is the method of ingestion. At the clinic that is currently making use of the substance, participants inject the drug themselves under the supervision of staff.
Called “heroin maintenance,” this fact is not insignificant. Continuing to engage in the practice that was a routine and daily practice during active addiction likely has a psychological impact on the participant. There is much subtler shift from injecting heroin at home to injecting a maintenance substance at a clinic as compared to taking methadone in liquid form at a clinic, taking buprenorphine lozenges at home, or being injected with Vivitrol once a month by a clinician.
For some clients, this subtlety may actually be beneficial. For those who lived for decades with an active heroin addiction and have been unsuccessful in establishing themselves in sobriety through the use of more conventional methods, it may help them to preserve their health and give back to their community, working and supporting themselves in a way that they may not otherwise be able to. Feeling psychologically closer to their former life in addiction – comfortable for them, if not healthy – may make a difference in their ability to avoid relapse and a return to an active and nonfunctional addiction.
For other clients, however, continuing to engage in a habit that is often romanticized and nostalgic for those in recovery from heroin addiction may not allow them to get the distance they need from that lifestyle – distance that will help them to fully ground themselves in recovery.
Unique Treatment Needs
As with all aspects of addiction treatment, the type and style of treatment that will be beneficial to a person will depend heavily upon:
- The dose of heroin ingested daily at the time of entrance into treatment
- The length of time spent in active heroin addiction
- The existence of co-occurring disorders
- The support available at home
- Personal goals for treatment and recovery
Though diacetylmorphine hydrochloride is not currently available in the United States, there are a number of different programs available to help clients navigate the detox process and transition into a stable and supported recovery.
In fact, for many people who are struggling with a heroin abuse problem or a low-dose addiction, medication may not be necessary or desired at all. Many clients prefer not to lengthen their time being dependent upon any substance, and choose instead to quit “cold turkey” with the use of medications only for the purpose of managing withdrawal symptoms. This can provide for a more rapid transition into total sobriety and a clearheaded focus on the therapeutic growth and healing that must take place in order to establish oneself in recovery for the long-term.
Prevention and Early Treatment
Treatment can be effective at any stage of addiction, and no matter what the circumstance, if someone is actively using heroin, treatment is always recommended. If the problem can be identified early, however, the transition into ongoing sobriety is more easily facilitated. To this end, there is a great push in different industries to improve best practices to ensure that those who need help get it as soon as possible.
For example, should someone be admitted to the emergency room for treatment due to injury related to painkiller misuse or heroin abuse, a study published in the journal Drug and Alcohol Dependence found that just one 30-minute therapy session with a trained clinician can motivate the patient to reduce their use and abuse of these substances, thus lowering their risk for accident under the influence, overdose, and addiction.
Dr. Amy Bohnert was lead researcher on the study. In a news release, she said: “It’s very promising that we see a reduction in risky behavior with this brief, one-time intervention, among people who weren’t seeking treatment for their opioid use but had a history of nonmedical use of these drugs. Further research is needed to understand if this leads to longer term impact on health.”
Connecting with Treatment Today
If someone you love is living with a dependence on heroin, now is the time to help them engage with treatment. Contact Greenhouse today to learn more about the options available for your loved one and begin the healing process for the entire family now.