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Report: It's Time To Start Clinical Trials On Medical-Grade Heroin Treatment

A report released Thursday by the RAND Corporation recommends that the federal government greenlight clinical trials on the effectiveness of medical-grade heroin for treating people with opioid addictions.

The recommendation is based on an extensive review of research on this medical intervention, which finds giving people access to medical-grade heroin reduces the chances of an overdose. Medical-grade heroin is commercially produced and patients inject it in a supervised setting.

Jonathan Caulkins, one of the report’s authors, specializes in drug policy at Carnegie Mellon University. He said in countries like Canada and the United Kingdom where heroin-assisted treatment is used, usually other medications, such as methadone, are tried first.

But those interventons don't always stop cravings. 

“It operates a lot like methadone, it’s a just a different molecule,” said Caulkins. “This is just giving them another drug that would be operating broadly in the same principle.”

Caulkins said when people with opioid use disorder have safe, stable access to heroin they are less likely to make risky or illegal decisions. He said this stability can help people eventually quit using opioids altogether.

The report also recommends the establishment of supervised injection sites, where opioid users can take illicitly-purchased drugs in a medically-supervised environment.  

There isn’t much evidence on whether these sites are successful, but the report said it made the recommendation based on the severity of the opioid epidemic; the RAND anaylsis finds the epidemic to be even more deadly than the peak of the HIV-AIDs crisis.

"There's a risk that waiting for difinitive proof may be waiting so long that many more people will die," Caulkins said.

A key benefit of supervised injection sites is that there are people present who are trained to revive someone from an overdose. Drug users are more likely to use clean needles, which mitigates the chances of contracting a bloodborne dises like HIV and Hepatitis. 

Some sites also provide referrals to treatment and access to drug content testing, as street drugs often are mixed with other, sometimes deadly substances.

Activists in Philadelphia are pushing to open what would be the country's first supervised injection site, despite pushback from the Trump Administration.

90.5 WESA receives funding from RAND.

Sarah Boden covers health and science for 90.5 WESA. Before coming to Pittsburgh in November 2017, she was a reporter for Iowa Public Radio. As a contributor to the NPR-Kaiser Health News Member Station Reporting Project on Health Care in the States, Sarah's print and audio reporting frequently appears on NPR and KFF Health News.