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Heroin Addiction and Related Clinical Problems: 2007, 09, 2 (pages: 5 - 10)

Can Heroin Maintenance Treatment Be Called a Therapy?

Guelfi G. P., Cibin M., Pani P. P., Maremmani I., For the Board of Directors of Italian Society of Addiction Medicine

Summary: Heroin administration may be reasonably accounted for in order to handle the cases of patients who proved refractory to methadone, despite repeated attempts and the employment of enhancement techniques to favour retention and rehabilitative processes. In most countries this is not the case, since standard effective treatments are often neglected or applied with unjustified limitations resulting in hampered effectiveness. As a consequence, effective treatment is far from being actually available to all those who apply for it, let alone those who may benefit from it. The first step to empower the addiction care system is to spread and enhance resources to grant patients with correct and powerful application of effective techniques, methadone/buprenorphine maintenance being regarded as the gold and first-line standard for the average addict. If that will ever be the case, as we hope, we would need to provide patients identified as refractory with a salvage option, along the concept of harm reduction. In any other context, the introduction of heroin administration programs would rather reduce the benefit than the harm