Science and politics of heroin prescription

Abstract

Heroin (diamorphine) was the trade name of a drug launched by Bayer in 1898,1 although it is now better known as an illicit drug responsible for infectious disease spread, fatal overdoses, and criminal activity.2,3 Methadone maintenance therapy is now the most widely investigated treatment for heroin addiction, with meta-analyses showing that such use of methadone is associated with a range of health and social benefits.4 However, even in countries where methadone is widely available through diverse sources, only 50–60% of heroin-dependent individuals are on methadone treatment,2 and 45–60% of opioid-dependent individuals who have previously failed or refused to access methadone cannot subsequently be retained in treatment, even when methadone provision is optimised.