Dutch team shows cost effectiveness of heroin prescriptions

Researchers at the University of Amsterdam say there are strong reasons to support the practice of prescribing heroin to drug misusers.

The Dutch team looked at 430 heroin addicts who were taking part in methadone maintenance programmes in six cities in the Netherlands.

Before they took part in the study, the addicts had frequently engaged in illegal activities to acquire money or drugs.

In the study they were given either methadone plus heroin, or methadone alone, and were then assessed after a year of treatment.

It was found that those given the combination treatment reported a better quality of life, compared to those given methadone alone, and the additional cost to health services was offset by savings linked to crime reduction.

The team says the treatment is cost-effective, even though it is expensive, and although the costs of co-prescription were found to be considerably higher, they were offset by lower policing costs and reduced costs of crime against property because addicts were not breaking the law to fund their habit.

They estimated the average total net savings amounted to over 12,500 euros per patient per year.

There is great controversy in the UK over the supervised medical prescription of the class A drug heroin.

UK experts say a range of treatments would need to be available as one kind of treatment will not work for all drug addicts

Previous research has already shown that supervised medical prescription of heroin improves the physical and mental health, and ability to function normally in society, of users who cannot be successfully treated using just methadone - a synthetic narcotic used to treat heroin addiction.

The researchers, led by Dr Marcel Dijkgraaf, say that from a societal perspective, supervised medical prescription of methadone plus heroin is less costly than methadone maintenance treatment, and co-prescription was cost effective for patients who had previously failed to stick to treatment with methadone alone.

A spokeswoman for the drugs charity Drugscope says it is important that there is a range of treatment options available, including heroin prescribing, and despite government indications in the past in favour of extending heroin prescribing, progress has been disappointingly slow.

She says the study adds weight to the argument in favour of extending heroin prescription, and shows that there are significant benefits in terms of health but also in terms of economic and social costs.

The study is published in the British Medical Journal.