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Heroin maintenance treatment (HAT) for chronic heroin users
Summary of the evidence
Heroin plus methadone prescription for maintenance treatment in adult chronic opioid users who failed previous methadone treatment attempts was found to be effective in a systematic review (Ferri et al. 2011, 8 RCT, N=2.007) in:
- remaining in treatment until the end of the study (RR 1.44, 95 % CI 1.19 to1.75);
- probably reducing the risk of death (RR 0.65, 95 % CI 0.25 to1.69).
The risk of adverse events was coherently high in all the seven studies providing comparable data (RR 13.50, 95 % CI 2.55 to 71.53).
A more recent systematic review and meta-analysis (McNair et al., 2023, eight studies n = 2331) found that supervised heroin-assisted treatment (HAT) leads to effective results in:
- patient retention [Z = 7.65 (P > 0.0001)]
