Driving the surge are potent, cheap synthetics like fentanyl that have spread into the illicit drug supply. In response, communities have been trying a range of interventions, from increasing the availability of the antidote naloxone to upping treatment resources.
But an analysis released Thursday by the Rand Corporation, a policy think tank, concludes it’s time to pilot an approach from outside the U.S.: offering pharmaceutical-grade heroin — yes, heroin — as a form of treatment for longtime heroin users who haven’t had success with other treatments. It’s already happening in several European countries and Canada. But prescribing heroin would challenge culture, laws and practice in the U.S.
Here’s how programs that offer prescription heroin, or heroin-assisted treatment, work:
Patients typically get a regular, measured dose of pharmaceutical-grade heroin — also known as diacetylmorphine or diamorphine — and inject it under close medical supervision inside a designated clinic.
The idea is if people have a legal source of heroin, they’ll be less likely to overdose on tainted street drugs, spend less time and energy trying to get their next fix, and instead be able to focus on the underlying drivers of their addiction.