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New aspects in the treatment of heroin dependence with special reference to neurobiological aspects

Published online by Cambridge University Press:  16 April 2020

Dieter Ladewig ,
Kenneth M. Dürsteler-MacFarland ,
Erich Seifritz ,
Christoph Hock  and
Rudolf Stohler
Dieter Ladewig*
Affiliation:
Department of Psychiatry, University of Basel, Wilhelm Klein-Strasse 27, CH-4025, Basel, Switzerland
Kenneth M. Dürsteler-MacFarland
Affiliation:
Department of Psychiatry, University of Basel, Wilhelm Klein-Strasse 27, CH-4025, Basel, Switzerland Department of Psychiatry, University of Zürich, Militärstr. 8. CH-8021, Zürich, Switzerland
Erich Seifritz
Affiliation:
Department of Psychiatry, University of Basel, Wilhelm Klein-Strasse 27, CH-4025, Basel, Switzerland
Christoph Hock
Affiliation:
Department of Psychiatric Research, University of Zürich, Lenggstrasse 31, CH-8029, Zürich, Switzerland
Rudolf Stohler
Affiliation:
Department of Psychiatry, University of Zürich, Militärstr. 8. CH-8021, Zürich, Switzerland
*
*Corresponding author. Tel.: +41-61-325-5132; fax: +41-61-325-5583 E-mail address: dieter.ladewig@pukbasel.ch (D. Ladewig).
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Summary

The Swiss trials on medical prescription of injectable diacetylmorphine (pharmaceutical heroin) for “severe” heroin dependence provoked very controversial commentaries. Despite methodological shortcomings, the evaluation of the Swiss heroin trials yielded some interesting findings. Study participants showed substantial improvements in health and well-being and noticeable declines in illicit drug use and criminal activities. Heroin prescription may thus be helpful for some of those who continue to regularly use illicit heroin while maintained on methadone or who refuse other available treatment options. However, research-based evidence suggests that the intravenous (IV) application of heroin under medical supervision may have untoward side effects. Recent studies have shown that heroin injections produce transient, but significant decreases in systemic and cortical oxygenation most likely secondary to respiratory depression. Among others, these effects are the subject of ongoing studies.

Keywords

HeroinIV maintenance treatmentNeurobiologyDeoxygenationNear-infrared spectroscopy
Type
Article original
Information
European Psychiatry , Volume 17 , Issue 3 , May 2002 , pp. 163 - 166
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS. 2002

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Footnotes

This article was presented at 5th AEP symposium, November 13–14, 1999, Strasbourg, France.

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