The North American Opiate Medication Initiative (NAOMI) study of diacetylmorphine (the active ingredient in heroin) versus methadone for the treatment of heroin and opioid addiction continues to be a source of controversy for anti-drug activists.
While the current standard of care for opiate addiction is opioid medications, the Canadian-based NAOMI study is founded on European findings that the use of heroin’s main chemical component is both effective and more cost efficient in the treatment of chronic opioid dependency.
Funded by the Canadian Institute of Health Research, 251 participants received treatment under the protocol of the highly debated Phase III randomized trial.
NAOMI Heroin Treatment Trial Outcomes
The study enlisted participants from Vancouver, Toronto and Montreal. Approximately half of the participants were given methadone, a synthetic opioid which is currently considered “standard of care” in the US medical community for opiate dependency. The other half of the trial participants received pharmaceutical-grade heroin in a tactic to which many American anti-drug activists are widely opposed.
Researchers reported in their findings that one year into the study, 90% of the addicts receiving heroin remained in treatment, as compared to about 50% of the methadone-receiving patients who remained in treatment. It was concluded that continued illegal drug use and conduct was decreased by 67% in those patients injected with diacetylmorphine, whereas researchers saw a 50% illegal conduct and other drug use activity decrease in patients undergoing methadone treatment.
(For more information on this study, click the link at the beginning of this article to be directed to an in-depth abstract with visuals and statistics depicting the trial’s findings.)
Harm Reduction vs. Long-Term Opiate Treatment
What ramifications would such a treatment strategy have on the opiate dependency community if adopted on a long-term basis? Some experts consider the NAOMI trial protocol objectives to be aimed more at harm reduction than full recovery. As such, do the the benefits of minimizing the effects of drug use on society (criminal behavior, lost productivity, etc.) outweigh those of a comprehensive treatment program?
Some consider harm reduction to be a necessary part of the overall opiate treatment picture, while others consider such programs to be “defeatist.” What value, if any, does harm reduction strategy have in heroin addiction treatment?
According to Gary W. Smith, treatment expert and Executive Director at Narconon Arrowhead Drug and Alcohol Treatment Facility, “All you have to do is look at history to know that providing heroin for addicts will not stop drug addiction. Other countries have tried this and all that happened is they wound up with an increasing number heroin addicts that were unemployable and who faced numerous drug related health care issues that required more federal and state monies to support.”
What Does it Take to Treat Heroin Addiction?
Treating heroin addiction requires comprehensive, long-term treatment in a residential (inpatient) setting. The combined effects of a safe, drug-free environment alongside round-the-clock care can be highly beneficial to addicts struggling to overcome a dependency as overwhelming as heroin.
Three of the main components of effective heroin addiction treatment are:
1. Underlying Issues – Digging deep enough to locate the underlying causes or precipitants for one’s substance abuse and its continuance lays the groundwork necessary for a drug-free future.
2. Biophysical Addiction (Physical Dependency and Nutritional Rebuilding) – On a cellular level, the body becomes dependent on heroin rather rapidly. Through the course of drug tolerance, a heroin consumer comes to find himself craving opiates and needing more and more of the drug to stave off the uncomfortable symptoms of withdrawal. Biophysical detox targets this important aspect of heroin addiction.
3. Life Skills – Key life skills are often forgotten or discarded in the course of substance abuse habits. Restoring these basic abilities is key to successful recovery.
Trial Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2639576/