Heroin-assisted treatment for opioid dependence - Randomised controlled trial
Heroin-assisted treatment for opioid dependence - Randomised controlled trial
复制标题
DOI：
10.1192/bjp.bp.106.026112
复制
发表时间：
2007-07-01
影响因子：
10.5
通讯作者：
Naber, Dieter
中科院分区：
文献类型：
--
作者：
Haasen, Christian;Verthein, Uwe;Naber, Dieter
目的研究海洛因辅助治疗对继续静脉注射海洛因的美沙酮依赖者和目前未接受治疗的海洛因依赖者的疗效。方法采用开放的多中心随机对照试验，对1015例海洛因依赖者分别给予不同剂量的注射海洛因(n=515)和口服美沙酮(n=500)治疗12个月。结果海洛因的保留率(67.2%)高于美沙酮组(40.0%)，海洛因组在两项主要结果指标上的反应均显著高于美沙酮组(40.0%)。海洛因组不良反应发生率较高，且主要与静脉注射有关。结论海洛因辅助治疗对阿片类药物依赖者在美沙酮维持期间持续静脉注射海洛因或未参加治疗的患者更有效。尽管风险较高，但在医疗监督下应考虑治疗耐药。
Background Heroin-assisted treatment has been found to be effective for people with severe opioid dependence who are not interested in or do poorly on methadone maintenance.Aims To study heroin-assisted treatment in people on methadone who continue intravenous heroin and in those who are heroin dependent but currently not in treatment.Method In an open-label multicentre randomised controlled trial, 1015 people with heroin dependence received a variable dose of injectable heroin (n=515) or oral methadone (n=500) for 12 months. Two response criteria, improvement of physical and/or mental health and decrease in illicit drug use, were evaluated in an intent-to-treat analysis.Results Retention was higher in the heroin (67.2%) than in the methadone group (40.0%) and the heroin group showed a significantly greater response on both primary outcome measures. More serious adverse events were found in the heroin group, and were mainly associated with intravenous use.Conclusions Heroin-assisted treatment is more effective for people with opioid dependence who continue intravenous heroin while on methadone maintenance or who are not enrolled in treatment. Despite a higher risk, it should be considered for treatment resistance under medical supervision.