Costly methadone treatment for heroin addicts could be replaced by a substitute painkiller that is half the price, safer and less toxic.
In a study spanning three and a half years, researchers found that the prescription painkiller dihydrocodeine is equally as effective as methadone to help drug users kick the habit.
The research by the Universities of Edinburgh, Napier and Adelaide could have major implications for treatment programmes for drug users, which have proved controversial not least because of the high costs involved.
In contrast to methadone –which comes in liquid not tablet form – dihydrocodeine is much easier to store and comes under less stringent regulations because it is not as toxic and less likely to cause a fatal overdose. It is estimated that whereas methadone treatment can cost almost £1,500 annually per patient, the cost of dihydrocodeine is £713.
Dihydrocodeine has been used by GPs and specialists for many years to treat drug users . It is often preferred in situations where methadone is seen as hazardous, such as police custody or prison. Its effectiveness has, however, never been tested before.
Dr Roy Robertson, a Reader at the University of Edinburgh, who is the study’s main author, said: "Heroin addiction is a chronic condition requiring long-term medication. Just as with other chronic conditions, such as diabetes or arthritis, there should be a number of treatments available so that doctors and nurses can tailor medication to the needs of each patient.
"Methadone should still be used to treat the majority of patients withdrawing from heroin and requiring maintenance treatment, but dihydrocodeine offers an alternative treatment for those who can’t tolerate methadone, or find it hard to deal with the stigma of having to take their dose – sometimes every day – in a pharmacy. It is also much cheaper."
The study, the first of its kind in the world, assessed 235 people requiring treatment for opiate dependency in Edinburgh and found that dihydrocodeine was just as effective as methadone.
Dr Roberston, who also works as a GP, added that while there were less restrictions attached to prescribing dihydrocodeine tablets, it is still essential that treatment regimes are controlled and tailored to the individual.
"We want to engage young people in a treatment programme which stops them from injecting drugs and running the risk of infection," he said.
"Apart from the danger of contracting AIDS, drug users run the real risk of exposure to the potentially fatal liver disease, Hepatitis C. We face an epidemic of Hepatitis C in Scotland, with 40% of young people who have been injecting drugs for more than two years being infected with this serious illness."
Results of the study, funded by the Chief Scientist Office, are published in the current edition of Addiction.
Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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