Treating Heroin Addiction ... With Opiate Addiction?

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When assessing the treatment of heroin addicts, many wonder whether the current approved options, methadone and suboxone, are effective pathways to recovery. But now that a recent study has found promise in the pain medication hydromorphone, we’re left to wonder how well heroin addiction can be treated with an addictive drug.

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When assessing the issue of treatment for heroin addicts, many wonder whether the current approved options, methadone and suboxone, are effective pathways to recovery. And now that a recent study has found promise in a pain medication called hydromorphone, one might wonder just how effective addictive drugs are when it comes to ... battling addiction.

The study, published in the Journal of the American Medical Association (JAMA) Psychiatryis part of a ground-breaking research project. The "Study to Assess Longer-term Opioid Medication Effectiveness," the SALOME project found that heroin addicts who have not used methadone or suboxone in the past may most benefit from the opiate hydromorphone, or HDM.

"While methadone and buprenorphine/naloxone are effective heroin addiction treatments for many people and should remain the first line responses, no single treatment is effective for all individuals," said Dr. Patricia Daly, quoted in press release publicizing the study. "Every person with severe opioid use disorder left untreated is at high risk of serious illness and premature death."

The SALOME study looked at over 200 Vancouver subjects who received either HDM or diacetylmorphine injections over a six-month period. The research team found HDM to be just as effective as diacetylmorphine in treating long-term opioid users. The team also found it to be just as safe: Out of a total 88,451 injections, only 14 overdoses and 11 seizures occurred.

"Providing injectable opioids in specialized clinics under supervision ensures safety of both the patients and the community, and the provision of comprehensive care," said SALOME's Principal Investigator, Dr. Eugenia Oviedo-Joekes.

But while the study found HDM an effective treatment for heroin addiction, does this in fact solve the problem? Or does it merely cause heroin addicts to become HDM addicts?

According to the U.S. National Library of Medicine, HDM can cause severe symptoms or death in users who have not developed an opioid addiction. The NLM cautions that there's a real risk of addiction and overdose from its use. It's commonly injected every two or three hours, but if stopped cold turkey HDM causes severe withdrawal symptoms, including sweating, chills, anxiety, muscle pains and stomach cramps.

For some, experiencing these symptoms might be an uncomfortable but acceptable tradeoff, if addiction to a more harmful drug, heroin, can be avoided. But the problem is that HDM addiction doesn't figure to be so different from heroin addiction. In fact, drug experts attest to the role prescribed painkillers -- namely OxyContin and Vicodin -- play in heroin addiction.

Between 2003 and 2013, heroin overdose deaths in the U.S. nearly quadrupled, according to the CDC. Experts claim that many of these deaths can be linked to painkiller abuse, since many painkillers come from the same poppy plant as heroin.

Just recently the U.S. Senate passed a bill seeking to combat both heroin and painkiller abuse. So we'd have to ask ourselves about the virtue of fighting heroin addiction with painkillers, when they cause similar symptoms and both lead to serious addiction.

With almost a quarter of heroin addicts also developing opioid addiction, according to the American Society of Addiction Medicine, it doesn't appear to make sense to employ a painkiller opiate, such as HDM, as a proper heroin addiction treatment.