How far-fetched the idea might seem to be, but, the use of heroin in supervised settings to manage opioid addiction is a reality.

Opioid addiction is one of the most crucial public health issues with an estimated number of 26.4 million and 36 million people abusing opioids worldwide. In the USA approximately 2.1 million people are affected by substance use disorders related to prescription opioid pain relievers and an estimated 467,000 are addicted to heroin. Although the use of Heroine prescription practice has still not approved for use in the USA, it is already in place in many European countries including Switzerland, Germany, Belgium, Netherlands, and the United Kingdom, under the name Heroin-assisted treatment programs – or HATs. The program is not limited to opioid addiction only and can be used for heroin addiction that has not responded to any other form of treatment.

Heroin-assisted treatment program offers unadulterated (pharmaceutical grade) heroin to individuals showing severe symptoms of opioid addiction. The concept of this intervention is that it helps in managing opioid withdrawal symptoms and provides some degree of relief to the person by mitigating the need to go out and search for heroin. Moreover, it also protects people from indulging in criminal activities to get some money to buy heroin. Pharmaceutical grade heroine does not have compounds like Fentanyl in it that lowers the risk of overdose. Additionally, it gives drug addicts an opportunity of interaction with health care services, which they usually miss, while on the streets or in their homes.

One of the oldest running heroine- assisted treatments (HAT) is in Switzerland, established in 1994. The data that emerged from the program showed many favorable outcomes including decrease in hepatitis and HIV spread and decreases in crimes committed. More interestingly, the number of new drug users also declined since the establishment of heroine assisted treatment centers. Experts in the drug dependence field postulate that heroin addiction has a definite stigma attached to it in society and people especially from younger generation wishing to rebel to social norms or who feel unfit in the societal structure usually are allured into using heroine. On the contrary, HAT program is presented as a medical treatment and is no more perceived as a counter-cultural or rebel mechanism. The use of medical graded heroine to treat opioid dependence should be investigated more through comprehensive research.


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