Heroin, opioid addiction a long-term disease: study

VANCOUVER — Addiction to heroin and other opioids is a long-term, chronic disease that can’t simply be fixed with a few weeks or months on methadone, a group of British Columbiabased researchers argue in a newly released paper.

Designing treatment based on the belief that most addicts can become drug-free quickly — or even at all — is ineffective and dangerous, the report warns.

The paper, published in the August edition of the journal Health Affairs, says research has repeatedly shown detoxification programs that use short-term bouts of methadone or similar therapies, reducing dosages over a period of weeks or months, are ineffective, with as many as 95 per cent of patients who complete such programs failing to stay clean.

One of the paper’s authors, Bohdan Nosyk of the B.C. Centre for Excel- lence in HIV/AIDS, said treatment programs that focus on abstinence as the end goal represent “the most damaging” aspect of opioid treatment in North America.

“This is a chronic disease, something that is going to have to be fought day by day over a long period — potentially a lifetime,” Nosyk said in an interview Tuesday.

“That’s difficult for people to accept. I still think there’s a demand that they want this problem dealt with quickly.”

Nosyk said public-health policies in Canada generally acknowledge that reality, but, in practice, some physicians and patients still hold onto the notion that treatment with methadone or its lesser-known counterpart, buprenorphine, should be a temporary stop on the way to abstinence.

The situation is worse in the United States, said Nosyk, where detoxification is an essential part of official drug-treatment policy.