For about two decades, prescription heroin was administered to patients. It was considered a wonder drug for its effectiveness in respiratory diseases. The Bayer Company originally started commercial production with heroin as a prescribed opioid narcotic in 1898. They eventually realized that giving someone heroin over and over would create tolerance and then heroin addiction. Things got worse. In 1910, people addicted to morphine realized the euphoric feelings heroin could offer. They found that the heroin effect could be heightened when taken intravenously. In the 1920s, heroin was pulled off the shelves. It’s been an illicit drug for almost a century. The strong stigma attached to heroin for so long was a deterrent for widespread use. The story of how heroin became used among urbanites thanks to the medical misuse of prescription pain killers is a shocking one. Thanks to mismanagement of drugs like Oxycodone, unlikely heroin addicts have emerged. The newest studies are showing that heroin is the way to save lives. After 100 years, it seems as though heroin could again be administered as a prescription.
The Evil Cycle of Heroin (Diacetylmorphine) and Opioid Prescription Pain Killers
Initially, heroin was the villain. Opioid prescription painkillers were the heroine. Strange how times have changed. The way people became so addicted to OxyContin, which was given away liberally and then taken away. The addiction was so great that non-addictive types of people were hooked. The people living in the countryside of the U.S. were hit hard with opioid use. Doctors were ill-equipped to help them with their pain. They turned to opioids instead of true rehabilitative therapy, and addiction was born. Then it was taken away. The drugs became more challenging for patients to get. Buying it off the streets was expensive. Heroin was cheap and it was also easier to get.
Opioid Pain Killers – The New Heroin
Everyone understands that heroin is a highly addictive, dangerous drug. What some people don’t realize is that prescription pain killers aren’t much better. Oxycontin and Percocet were highly prescribed opioids for pain. They contain oxycodone with molecular structures nearly identical to diacetylmorphine. Brand names of opioids are ever-changing but the highly addictive ingredients remain the same. These opioid narcotics derive from the same thing heroin does-the opium poppy. They have the same effect on the mind and the body. They are becoming interchangeable addictions. This means the heroin problem isn’t going away. Neither are prescription pain killer addictions. The death and addiction we’re seeing now due to prescription opioids have surpassed illicit drugs.
Urbanites Getting Hooked on Heroin
Heroin addiction has a stereotype. We often think it’s the homeless guy or the rock star found dead with a needle in his arm. The demographic, however, has changed. So many people who’ve suffered an injury in the U.S. are given prescription pain killers. The general public is given drugs that caused addiction and they didn’t see it coming. These urbanites were not the kind of people that you’d expect would become addicts. Medical professionals and addiction experts have seen the rise of heroin use. They have seen the connection between cutting off prescription pain killers and heroin abuse. There is no specific person looking for heroin on the streets anymore. It’s the guy in computer sales buying heroin to stave off withdrawal symptoms from Percocet addiction. A drug he was given after a surgery or injury. On the streets, oxycodone is expensive at $10 per 10 mg pill. Most people that are addicted will have a high tolerance. They need a lot of 10 mg pills to feed their addiction. Heroin costs less at $5 per bag which can last an addict all day. Once urbanites begin to get into heroin, it’s a pretty fast addiction. Almost immediate actually. The heroin withdrawal symptoms are nearly unbearable. Inpatient detox and rehab can help greatly if the person wants help. There are about 30,000 people dying from heroin overdose yearly. So it’s a matter of getting help or eventually dying because of your addiction.
Prescription Heroin (Diamorphine) – Who Will Be Getting Treatment?
Pharmacological treatment of opioid addiction for heroin and prescription drugs helps decrease use. It is also helpful in decreasing infectious disease and criminal activity. Many people scoff at the idea of using diamorphine as a means of therapy. The heroin epidemic is real. It’s not a scare tactic. Using prescription heroin to help fight the opioid problem is plausible due to desperation. The fact is, there are certain opiate addicts who need different heroin-assisted treatment. With any addiction, there is not a one-size-fits-all solution. There are up to 15% of opioid users that won’t get benefit from other treatments. Suboxone doesn’t work for them and methadone hasn’t been effective either. Nothing works. They will keep relapsing which is dangerous when taking heroin, and they will likely die. The only treatment that will work is by giving them prescription heroin. Doses that are under medical supervision.
The Logic Behind Prescription Heroin (Diamorphine)
For certain heroin addicts, they are so attached to the drug that withdrawal is not an option. They are going to use it. Giving them a safe source of the drug prevents death. They also have a safe place to inject with clean needles. Medical-grade heroin, also known as diacetylmorphine, is administered. Nurses are monitoring the addict and have Naloxone in case of an overdose. These heroin addicts don’t have to steal anymore which reduces crime. Heroin prescription treatment is a last resort when everything else has failed. The treatment is effective. Nobody has died in a heroin prescription administering the clinic.
SALOME – The Clinical Study for Diacetylmorphine on Heroin Treatment
Currently, there are studies like SALOME happening around the world. Well in Canada, Switzerland, and Germany anyway. SALOME stands for The Study to Assess Longer-term Opioid Medication Effectiveness. It’s one example of a clinical study that took place in Vancouver, BC, Canada. It tests alternative treatment for those who are addicted to heroin. In their study, they tested two medications against each other – diacetylmorphine and hydromorphone. Similar studies happening in Europe are proving that diacetylmorphine is more effective than oral methadone. This is based on vulnerable heroin users. The study involved a particular type of heroin user. They were not benefitting from methadone or other treatments. They were users that had a documented heroin addiction for at least five years. What the study concluded; For those who don’t gain benefits from methadone or suboxone, hydromorphone or diacetylmorphine can be the next alternative. This intensified treatment option should be conducted under supervision. Perhaps they’ll incorporate it into inpatient heroin addiction treatment programs if approved.
Diacetylmorphine, One More Solution for the Fight Against Opioids
The U.S is experiencing its most deadly drug overdose crisis in history. Addiction care is an essential part of helping reduce the abuse, accidents, crime, overdose, and deaths related to heroin use. Countries that are introducing prescription heroin as a treatment option believe that there are benefits. They feel it offers additional hope in the fight against opioids. In 2015, more than 50,000 people died from over drug overdoses in the U.S. Well over half of those deaths were somehow connected to opioids. Bryce Pardo and Peter Reuter are drug policy experts. They had this to say about heroin prescription therapy. “Heroin-assisted therapy addresses the immediate overdose threat posed by fentanyl — something naloxone attempts to do after the fact. Prescribed heroin use in a clinical and supervised setting ensures that users are not consuming fentanyl and that staff are on hand should something go wrong.” Opioids have become such a huge problem in the U.S. There are varying degrees of addiction. For each type of addiction, there should be a solution. For some, the only solution is to get a dose of the drug they’re addicted to.
Sources:
NCBI, PubMed. Br J Clin Pharmacol. (Dec. 2008). Oral diacetylmorphine (heroin) yields greater morphine bioavailability than oral morphine: bioavailability related to dosage and prior opioid exposure. Retrieved from, https://www.ncbi.nlm.nih.gov/pubmed/18945270 NCBI, Rev Med Liege. (June 2013) Heroin. Retrieved from, https://www.ncbi.nlm.nih.gov/pubmed/23888578 NCBI, CNS Drugs (2009) Prescription of heroin for the management of heroin dependence: current status. Retrieved from, https://www.ncbi.nlm.nih.gov/pubmed/19480466 NCBI, Substance Abuse Treatment, Prevention and Policy (2015). The SALOME study: recruitment experiences in a clinical trial offering injectable diacetylmorphine and hydromorphone for opioid dependency. Retrieved from, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355145/ BJ Psych. The British Journal of Psychiatry (Jul 2015). Heroin on trial: systematic review and meta-analysis of randomised trials of diamorphine-prescribing as treatment for refractory heroin addiction. Retrieved from, https://bjp.rcpsych.org/content/207/1/5