About half of participants in a study that involved injecting opioid-dependent individuals with medically prescribed pharmaceutical-grade heroin or hydromorphone did not use illicit heroin in the 30 days prior to each of the study’s assessment dates.
Importantly, researchers found an independent effect of attendance for treatment, suggesting benefits from the supervised model of care at clinics “that go beyond the provision of the medication alone,” wrote Eugenia Oviedo-Joekes and her associates.
Participants in the North American Opiate Medication Initiative (NAOMI) clinical trial had made a minimum of two prior attempts to treat their opioid dependence, including at least one methadone maintenance treatment (MMT), and had gone without MMT for 6 months prior to the trial’s start date. The study had the additional inclusion criterion of 5 or more years of opioid dependence.
Data collection, which was done every 3 months, revealed that 47.5%-54.0% of the study’s participants were not using illicit heroin in the prior month. Independent predictors of nonuse or low use of illicit heroin included fewer days involved in illicit activities at baseline and in the prior month, less ongoing cocaine use and money spent on illicit drugs, more days engaged in drug treatment, and a higher dosage of DAM (diacetylmorphine) or HDM (hydromorphone) in the prior month.
An additional finding of the study was that involvement in illegal activities before starting drug treatment independently predicted illegal heroin use in the past month after starting treatment.
Find the full study in Addictive Behaviors (doi:10.1016/j.addbeh.2014.10.003).