2826 – Referral of heroin addicts from syringe exchange to evidence-based treatment - a randomized controlled trial

Abstract

Syringe exchange has been suggested as a potential conduit to treatment for drug addiction. This has been tried in a few US trials, but never in Europe. This study aims to assess effectiveness of a syringe exchange for referral of heroin addicts to evidence-based treatment, and to assess, in an RCT design, the contribution of a case management intervention. Consecutive heroin addicts attending the syringe exchange of Malmö, Sweden, who are willing to participate, are referred to maintenance treatment (methadone or buprenorphine, medication based on clinical assessment and outside the study design), and randomized to either a strength-based case management intervention in order to facilitate referral, or referral-only. If eligible for treatment, patients are initiated on the maintenance treatment after 12 days. Study outcome is successful transfer from syringe exchange to treatment initiation. The study is currently being finalized, and final results (N = 70–75) will be available before presentation at the EPA congress. Pilot data from the first phase of recruitment revealed that among 21 patients, 16 (76%) were willing to join the study. Among them, all 16 successfully showed up for medical assessment, and all but one (94%) successfully initiated medication. Preliminary follow-up until today confirm a similar picture. Pilot data indicate that syringe exchange can be used for transfer to evidence-based treatment in heroin addiction. High rates of patients are successfully transferred to treatment, with or without a facilitating case management intervention. Final results will be presented at the congress.