Should We Consider Prescription Heroin To Treat Drug Addiction in the United States?

An important report from the RAND Corporation argues that prescription heroin is actually effective at treating opioid addiction. The report takes evidence from programs in Australia, Canada, and Europe which approach opioid treatment in a very specific way. These programs are harm reduction intervention strategies which use some unconventional methods:  prescription heroin and supervised drug consumption sites.  Obviously, these methods are quite controversial in the United States (even though they are quite successful in other parts of the world).

Also called heroin-assisted therapy (HAT), the RAND report comments that prescription heroin might seem counterintuitive at first glance, but at these prescription heroin sites, strategists provide medical-grade heroin to those who are addicted to opioids.

Essentially the idea looks at the fact that you cannot simply stop an addict from using; an addict will feed their addiction if they want to (and most of the time, that is the choice they make).  The goal, then, is to allow for addicts to inject safer (again, “medical-grade”) drugs than the stuff they will pick up on the street (because that stuff can be—and often is—laced with the far more potent and far more dangerous fentanyl) which can lead to possible overdose.  Through medical supervision of heroin use, then, patients not only dramatically reduce the risk of death by overdose, but they also do not have to commit crimes in order to fund their habit.

The other method is known as supervised consumption. In this harm-reduction strategy, medical professionals supervise drug use and actually provide sterile injection equipment.  In addition, the supervisors are equipped with the opioid overdose intervention treatment naloxone, just in case.  And these supervisors are also able to connect users to treatment centers on request.

But while the evidence suggests that these programs are effective at saving lives in many parts of the world, it has yet to take hold in the United States.  Ironically, the United States is one place where a novel approach may be a good idea. Last year, alone, reports indicate more than 70,000 people died as a result of drug overdoses and approximately half of these deaths involved either heroin or fentanyl.  The issue is so bad, in fact, that US President Trump declared, last year, that the US is amid an overdose crisis, and that we should consider drug overdose a public health emergency.