{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:56:46Z","timestamp":1790708206993,"version":"4.1.0"},"reference-count":23,"publisher":"Royal College of Psychiatrists","issue":"1","license":[{"start":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T00:00:00Z","timestamp":1514851200000},"content-version":"unspecified","delay-in-days":3838,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2007,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Heroin-assisted treatment has been found to be effective for people with severe opioid dependence who are not interested in or do poorly on methadone maintenance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To study heroin-assisted treatment in people on methadone who continue intravenous heroin and in those who are heroin dependent but currently not in treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>In an open-label multicentre randomised controlled trial, 1015 people with heroin dependence received a variable dose of injectable heroin (<jats:italic>n<\/jats:italic>=515) or oral methadone (<jats:italic>n<\/jats:italic>=500) for 12 months. Two response criteria, improvement of physical and\/or mental health and decrease in illicit drug use, were evaluated in an intent-to-treat analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Retention was higher in the heroin (67.2%) than in the methadone group (40.0%) and the heroin group showed a significantly greater response on both primary outcome measures. More serious adverse events were found in the heroin group, and were mainly associated with intravenous use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Heroin-assisted treatment is more effective for people with opioid dependence who continue intravenous heroin while on methadone maintenance or who are not enrolled in treatment. 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