Journal of Substance Abuse Treatment
Volume 38, Issue 4 , Pages 408-411 , June 2010

Double-blind injectable hydromorphone versus diacetylmorphine for the treatment of opioid dependence: A pilot study

  • Eugenia Oviedo-Joekes, Ph.D.

      Affiliations

    • School of Population and Public Health, University of British Columbia
    • Centre for Health Evaluation & Outcome Sciences, Providence Health Care
    • Corresponding Author InformationCorresponding author. St. Paul's Hospital, Vancouver, BC, Canada V6Z 1Y6. Tel.: +1 604 682 2344x62973; fax: +1 604 806 8210.
    • ,
  • Daphne Guh, M.Sc.

      Affiliations

    • Centre for Health Evaluation & Outcome Sciences, Providence Health Care
    • ,
  • Suzanne Brissette, M.D.

      Affiliations

    • Centre Hospitalier de l'Université de Montréal
    • ,
  • David C. Marsh, M.D., C.C.S.A.M.

      Affiliations

    • School of Population and Public Health, University of British Columbia
    • Centre for Health Evaluation & Outcome Sciences, Providence Health Care
    • Department of Psychiatry, University of British Columbia
    • Vancouver Coastal Health & Providence Health Care
    • Centre for Addiction Research BC, University of Victoria
    • ,
  • Bohdan Nosyk, Ph.D.

      Affiliations

    • Centre for Health Evaluation & Outcome Sciences, Providence Health Care
    • ,
  • Michael Krausz, M.D., Ph.D.

      Affiliations

    • Centre for Health Evaluation & Outcome Sciences, Providence Health Care
    • Department of Psychiatry, University of British Columbia
    • ,
  • Aslam Anis, Ph.D.

      Affiliations

    • School of Population and Public Health, University of British Columbia
    • Centre for Health Evaluation & Outcome Sciences, Providence Health Care
    • ,
  • Martin T. Schechter, M.D., Ph.D

      Affiliations

    • School of Population and Public Health, University of British Columbia
    • Centre for Health Evaluation & Outcome Sciences, Providence Health Care

Received 15 September 2009 ,Revised 2 March 2010 ,Accepted 2 March 2010.

References 

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  2. Bammer G, Dance P, McDonald D. Report into the feasibility of trialling hydromorphone as a treatment for heroin dependence in the Australian Capital Territory. Australian National University; 2004;
  3. Brands B, Marsh D, Busto U, Macdonald A. Comparison of heroin and hydromorphone in opioid users. Clinical Pharmacology & Therapeutics. 2004;75:P3
  4. Degenhardt L, Randall D, Hall W, Law M, Butler T, Burns L. Mortality among clients of a state-wide opioid pharmacotherapy program over 20 years: risk factors and lives saved. Drug & Alcohol Dependence. 2009;105:9–15
  5. Gowing L, Farrell M, Bornemann R, Sullivan L, Ali R. Substitution treatment of injecting opioid users for prevention of HIV infection. Cochrane Database System Review. 2008;2:CD004145
  6. Greenwald MK, Hursh SR. Behavioral economic analysis of opioid consumption in heroin-dependent individuals: Effects of unit price and pre-session drug supply. Drug & Alcohol Dependence. 2006;85:35–48
  7. Haasen C, Verthein U, Degkwitz P, Berger J, Krausz M, Naber D. Heroin-assisted treatment for opioid dependence: Randomised controlled trial. British Journal of Psychiatry. 2007;191:55–62
  8. Hall WD, Kimber J, Mattick RP. Breaking the deadlock over an Australian trial of injectable opioid maintenance. Medical Journal of Australia. 2002;176:72–73
  9. Health Canada . Best practices in methadone maintenance treatment. Ontario, Canada: Minister of Public Works and Government Services Canada; 2002;
  10. ICH Harmonised Tripartite Guideline . Guideline for good clinical practice. EMEA. 2002;
  11. Kokkevi A, Hartgers C. EuropASI: European adaptation of a multidimensional assessment instrument for drug and alcohol dependence. European Addiction Research. 1995;1:208–210
  12. March JC, Oviedo-Joekes E, Perea-Milla E, Carrasco F. Controlled trial of prescribed heroin in the treatment of opioid addiction. Journal of Substance Abuse Treatment. 2006;31:203–211
  13. Oviedo-Joekes E, Brissette S, Marsh DC, Lauzon P, Guh D, Anis A, et al. Diacetylmorphine versus methadone for the treatment of opioid addiction. New England Journal of Medicine. 2009;361:777–786
  14. Oviedo-Joekes E, Nosyk B, Brissette S, Chettiar J, Schneeberger P, Marsh DC, et al. The North American Opiate Medication Initiative (NAOMI): Profile of participants in North America's First Trial of Heroin-Assisted Treatment. Journal of Urban Health. 2008;85:812–825
  15. Oviedo-Joekes E, Nosyk B, Marsh D, Guh D, Brissette S, Gartry C, et al. Scientific and political challenges in North America's first randomized controlled trial of heroin-assisted treatment for severe heroin addiction: Rationale and design of the NAOMI Study. Clinical Trials. 2009;6:261–271
  16. Pharmascience Inc . Hydromorphone, product monograph. 1996;
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  18. Quigley C, Wiffen P. A systematic review of hydromorphone in acute and chronic pain. Journal of Pain Symptom Management. 2003;25:169–178
  19. Rehm J, Gschwend P, Steffen T, Gutzwiller F, Dobler-Mikola A, Uchtenhagen A. Feasibility, safety, and efficacy of injectable heroin prescription for refractory opioid addicts: A follow-up study. Lancet. 2001;358:1417–1423
  20. Sacerdote P, Franchi S, Gerra G, Leccese V, Panerai AE, Somaini L. Buprenorphine and methadone maintenance treatment of heroin addicts preserves immune function. Brain Behavior & Immunity. 2008;22:606–613
  21. Strain EC, Walsh SL, Bigelow GE. Blockade of hydromorphone effects by buprenorphine/naloxone and buprenorphine. Psychopharmacology (Berl). 2002;159:161–166
  22. van den Brink W, Hendriks VM, Blanken P, Koeter MW, van Zwieten BJ, van Ree JM. Medical prescription of heroin to treatment resistant heroin addicts: Two randomised controlled trials. British Medical Journal. 2003;327:310
  23. Wallenstein SL, Houde RW, Portenoy R, Lapin J, Rogers A, Foley KM. Clinical analgesic assay of repeated and single doses of heroin and hydromorphone. Pain. 1990;41:5–13

 The authors designed the study and gathered the data. The senior statistician (D.G.) performed the data analyses. The first (E.O.J.) and last author (M.T.S.) wrote the first draft of the paper, and all authors contributed to the final version. The final decision about publishing the paper was made by all the authors. All authors vouch for the accuracy of the data and analysis.

 Competing interests: All authors declare that the answer to the questions on the competing interest form are all No and therefore have nothing to declare.

 Funding: The study is funded by the Canadian Institutes of Health Research.

PII: S0740-5472(10)00063-2

doi: 10.1016/j.jsat.2010.03.003

Journal of Substance Abuse Treatment
Volume 38, Issue 4 , Pages 408-411 , June 2010

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