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The impact of heroin addiction

The impact of a heroin addiction both on the individual’s health and lifestyle, including social issues around criminal activities have led to a range of treatment options being explored. Alongside residential treatment at rehab clinics which offer detox and psychological treatment, a range of community treatment options have been explored.

One of the most common community treatment types is a methadone maintenance programme. This has been shown to have a large effect on the social outcomes and negative impacts of addiction for the individual (Harris et al., 2006). However concerns have been raised regarding this form of treatment, which is especially pertinent as it is the most common treatment offered by NHS services for those with a heroin addiction. The criticisms surround the maintenance of methadone, as the prescription of methadone can be made for several years with individuals struggling to gradually reduce and become substance free. The effects of opiates can also be felt whilst using methadone, which creates issues with co-use of methadone and opiates such as heroin (Darke, Ross & Hall, 1996).

An alternative to methadone is a Naltrexone programme. This block the pleasurable effects of heroin, which means service users taking Naltrexone are discouraged from relapsing as they are not able to achieve the effects they crave (Ngo, Tait & Hulse, 2008). A return to heroin use can be fatal following a period of abstinence, meaning preventative medication can be advantageous. However, if taken orally individuals using Naltrexone can drop out of the programme and engage once again in illegal drug use. This highlights the importance of treatment which focuses on the psychological addiction as well as the physical cravings and effects. 

Ngo, Tait and Hulse (2008) completed a study in Australia also looked at the associated morbidity rates over a short and long term period of receiving naltrexoneimplant treatment. The study showed that whereas methadone had high morbidity rates following opiate overdose, Naltrexone lead to higher risk of overdose from other non-opiate drugs. This highlights the need to address the underlying reasons behind a relapse, and for full relapse prevention provisions to be in place.

Treatment centres aim to give individuals the tools to avoid relapse through highlighting their trigger points, and teaching them what to do in vulnerable times. It is also important not to underestimate the value of additional psychological support and community care. Future research on the combination of preventative medication and psychological treatment may identify the benefits of combining approaches.

References

Darke S, Ross J, Hall W. (1996) Overdose among heroin users in Sydney, Australia, I: prevalence and correlates of non-fatal overdose. Addiction.;91(3):405-411.

Harris KA, Arnsten J, Joseph H, Hecht J, Marion I, Juliana P, Gourevitch M. (2006). A 5-year evaluation of amethadone medical maintenance program. J Subst AbuseTreat.;31(4):433-438.

Ngo, H.T., Tait, R.J., & Hulse, G.K. (2008). Comparing drug-related hospital morbidity following heroin dependence treatment with methadone maintenance or naltrexone implantation. Archives of General Psychiatry, 65(4), 457-65.

Published by on 06/12/2020.

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