IN GERMANY, FAVORABLE HEROIN TRIAL RESULTS, UNFORTUNATE AND UNWARRANTED COMPARISON TO METHADONE TREATMENT

Favorable results of the multi-year, seven-city pilot project that provided heroin to long-term opiate addicted individuals have led the city government of Frankfurt to overwhelmingly approve continuation of heroin maintenance, and to push for federal approval to legalize prescribing of heroin. What is unfortunate is that the pilot study chose as a “control” group subjects who were given methadone – even though, as required by the eligibility criteria, virtually all had failed to achieve positive outcomes with methadone maintenance in the past.

First, this amounts to testing one regimen whose outcomes are not known, to another that has a proven record of failure with the subjects studied. Secondly, virtually all those who volunteered to participate were surely motivated by the desire to obtain heroin, rather than the medication that had previously been ineffective. Whatever the groups randomly assigned to the two “arms” of the study may have had in common, their desire for and expectations of heroin as opposed to methadone could not have been more different. The results of the comparison were inevitable. Thus, the recent (March 11, 2006 – redaktion rhein-main) press report noted the success of heroin compared to methadone in improving drug use, health and social status.

So will there be immediate adverse consequences of the findings, as reported, of the German trial, stating that heroin is “more effective” than methadone? Hopefully not, but it will certainly lend support to those who already hold a strongly pejorative view of the latter in many countries of the world. .