By Sy Mukherjee
December 6, 2018

Just how bad is America’s epidemic of opioid painkiller (legal and illicit alike) addiction and overdose epidemic? A new expert analysis from the RAND Corporation suggests that prescribing heroin (yes, that heroin) could be an effective tool for combating the crisis in extreme circumstances.

“Given the increasing number of deaths associated with fentanyl and successful use of heroin-assisted treatment abroad, the U.S. should pilot and study this approach in some cities,” says Beau Kilmer, co-director of the RAND Drug Policy Research Center, in a statement. “This is not a silver bullet or first-line treatment. But there is evidence that it helps stabilize the lives of some people who use heroin.”

To be clear, the RAND analysis focuses on individuals who have severe opioid addiction – those whose disease isn’t effectively treated by the traditional methods, such as conventional medication assisted therapy and rehab through the use of products such as methadone and buprenorphine.

But the study authors point out that some of the highest-risk patients still wind up injecting illegal street opioids while undergoing treatment with those substances, substantially raising their risk of overdose death. For these people, “heroin-assisted treatment” may prove an effective, if controversial, measure, especially since prescription grade heroin is far less likely to harbor contaminants or be cut with other dangerous chemicals.

Whether or not such initiatives would be widely adopted is another question. Clean needle exchange programs for drug users and “safe injection sites” have been matters of serious controversy, and they don’t involve directly providing heroin to users.

Whatever your viewpoint, RAND’s entire analysis is worth reading in full.

Read on for the day’s news.

Sy Mukherjee


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