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USA. The Strongest Evidence Yet for a Highly Controversial Addiction Treatment

When other approaches fail, the most effective way to fight a heroin addiction can be heroin itself. (The Atlantic, USA, 08.12.2018)

https://www.theatlantic.com/health/archive/2018/12/prescription-heroin-opioids/577615/

Considering Heroin-Assisted Treatment and Supervised Drug Consumption Sites in the United States.

Kilmer, Beau, Jirka Taylor, Jonathan P. Caulkins, Pam A. Mueller, Allison J. Ober, Bryce Pardo, Rosanna Smart, Lucy Strang, and Peter H. Reuter

Santa Monica, CA: RAND Corporation, 2018. 

https://www.rand.org/pubs/research_reports/RR2693.html

Facing fentanyl: should the USA consider trialling prescription heroin?

Pardo, Bryce et al.

The Lancet Psychiatry , Volume 0 , Issue 0 , Published: 22 March 2018, doi.org/10.1016/S2215-0366(18)30103-2

http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(18)30103-2/fulltext

Schweiz. Wegweisende Drogenpolitik – 25 Jahre kontrollerte Heroinabgabe in Zürich (Video)

Die Bilder der offenen Drogenszene vom Zürcher Platzspitz und vom Letten gingen um die Welt. Jahrelang versuchte die Stadt Zürich Bundesbern von ihrem Testprojekt zu überzeugen. Entstanden ist die Vier-Säulen-Drogenpolitik, die heute noch angewendet wird. (SRF – Schweizerischer Rundfunk, Schweiz aktuell, 30.11.2018, Video, 03:36)

https://tp.srgssr.ch/p/portal?urn=urn:srf:video:623f55e2-eede-40df-8391-e94aad911318&autoplay=true&legacy=true&width=640&height=360&playerType

Berlin. Berliner Praxis „Patrida“: Heroin auf Rezept für Suchtkranke

„Dr. Peschel hat mir das Leben gerettet.“ Was nach Pathos klingt, meint Thomas ernst. Der 57-Jährige ist seit mehr als 30 Jahren heroinabhängig. In der Berliner Praxis „Patrida“, die der Psychiater Thomas Peschel vor fünf Jahren eröffnet hat, bekommt er zwei Mal am Tag Diamorphin auf Rezept - reines Heroin. Bis heute ist die Praxis die einzige ihrer Art in der Hauptstadt, obwohl der Bedarf größer wäre. (Berliner Kurier, 21.03.2018)

https://www.berliner-kurier.de/berlin/kiez---stadt/berliner-praxis--patrida--heroin-auf-rezept-fuer-suchtkranke-29902012

Einleitung einer Substitutionsbehandlung mit Buprenorphin unter vorübergehender Überlappung mit Heroinkonsum: ein neuer Ansatz („Berner Methode”)

Induction of a Buprenorphine Substitution Treatment with Temporary Overlap of Heroin Use: A New Approach (“Bernese Method”)R. Hämmig

Suchttherapie 2010; 11(3): 129-132, DOI: 10.1055/s-0030-1261914

Abstract

https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0030-1261914

Eligibility for heroin-assisted treatment (HAT) among people who inject opioids and are living with HIV in a Canadian setting.

Klimas J, Dong H, Fairbairn N, Socías E, Barrios R, Wood E, Kerr T, Montaner J, Milloy MJ.

Addict Sci Clin Pract. 2018 Feb 7;13(1):3. doi: 10.1186/s13722-017-0104-y.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812056/

Düsseldorf. The Doctor Treating Heroin Addiction With Heroin

Dr. Christian Plattner wants to encourage more medical specialists to use diamorphine to treat severe addictions. (vice, UK, 17.09.2018)

https://www.vice.com/en_uk/article/7xqnyq/the-doctor-treating-heroin-addiction-with-heroin

USA. New Mexico Passes Legislation to Examine Administering Pharmaceutical-grade Heroin or Other Opioids by Medical Practitioners to People Struggling with Long-term Addiction

With Growing Interest by Elected Officials, Academic Researchers, and Clinicians, New Mexico is Positioned to be one of the First States to Open a Supervised Injectable Opioid Treatment Program.

Supervised Injectable Opioid Treatment Remains Unutilized in the United States, But Proven Effective Around the World Including in Canada, Switzerland, the Netherlands, Germany, and Denmark. (Drug Policy Alliance, 14.02.2018)

http://www.drugpolicy.org/press-release/2018/02/new-mexico-passes-legislation-examine-administering-pharmaceutical-grade

Düsseldorf. Ein Arzt erzählt, warum er seine Patienten mit reinem Heroin versorgt

Für Christian Plattner ist der Stoff ein Medikament, das traumatisierten Menschen ein besseres Leben bringen kann. (vice.com/de, 31.08.2018)

https://www.vice.com/de/article/7xqnyq/drogen-therapie-warum-ein-arzt-patienten-mit-reinem-heroin-versorgt

Safety profile of injectable hydromorphone and diacetylmorphine for long-term severe opioid use disorder.

Oviedo-Joekes E, Brissette S, MacDonald S, Guh D, Marchand K, Jutha S, Harrison S, Janmohamed A, Zhang DZ, Anis AH, Krausz M, Marsh DC, Schechter MT.

Drug Alcohol Depend. 2017 Jul 1;176:55-62. doi: 10.1016/j.drugalcdep.2017.02.021.

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/28521199

Supervised Injectable Opioid Treatment for the Management of Opioid Dependence.

Bell J, Belackova V, Lintzeris N.

Drugs. 2018 Aug 21. doi: 10.1007/s40265-018-0962-y.

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/30132259

Direct-acting antiviral therapy for hepatitis C infection among people receiving opioid agonist treatment or heroin assisted treatment.

Scherz N, Bruggmann P, Brunner N.

Int J Drug Policy. 2018 Oct 24;62:74-77. doi: 10.1016/j.drugpo.2018.10.003.

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/30368101

Norwegen. Norway to be 7th European Country to Offer Heroin Assisted-Treatment

Norway will offer free heroin prescriptions through a heroin-assisted treatment (HAT) programme by 2020 in an attempt to improve the living conditions of people dependent on the drug. (Talking Drugs, UK, 20.08.2018)

https://www.talkingdrugs.org/norway-to-be-7th-european-country-to-offer-heroin-assisted-treatment

UK. West Midlands addicts to be prescribed heroin under bold plans to combat 'scourge of drugs'

West Midlands police commissioner announces "fresh ideas" to tackle drug problems.

Users offered heroin in drug consumption rooms and if other forms of treatment fail.

Move welcomed as drug use increasingly considered public health issue rather than criminal. (IB Times, 12.02.2018)

http://www.ibtimes.co.uk/addicts-be-prescribed-heroin-under-bold-plans-combat-scourge-drugs-1660684

Norwegen. Norwegen testet Heroin auf Rezept

Oslo – Norwegen plant einen Test mit Heroin auf Rezept für besonders schwer Süchtige. Ziel sei es, „denjenigen Drogenabhängigen zu einer besseren Lebensqualität zu verhelfen, die wir bislang nicht mit Hilfsprogrammen erreichen“, schrieb Gesundheitsminister Bent Höie auf Facebook. (aerzteblatt.de, 10.08.2018)

https://www.aerzteblatt.de/nachrichten/97081/Norwegen-testet-Heroin-auf-Rezept

Positionspapier: Einrichtung einer Clearingstelle Diamorphin (Deutsche Suchtgesellschaft – Dachverband der Suchtfachgesellschaften (DSG)

Die aktuelle gesetzliche Regelung im BtMVV zur diamorphingestützten Behandlung schwerst-opiatabhängiger Menschen gibt klare und strenge Ein- bzw. Ausschlusskriterien vor Aufnahme eines opiatabhängigen Patienten in das Diamorphinvergabeprogramm vor. Die aktuelle Version sieht keinerlei Ausnahmeregelungen vor.

Der Dachverband der Deutschen Suchtgesellschaften (DSG; Mitglieder: Deutsche Gesellschaft für Suchtmedizin - DGS, Deutsche Gesellschaft für Suchtforschung und Suchttherapie - DG-Sucht e.V., Deutsche Gesellschaft für Suchtpsychologie dgsps) stellt in Kooperation mit der Arbeitsgemeinschaft der Diamorphin-Substitutionsambulanzen in Deutschland fest, dass hierdurch immer wieder Menschen der Zugang zu dieser Behandlungsform verwehrt werden muss, obwohl mit dieser Behandlungsform eine konkrete Gefahr für die betroffene Person abgewendet werden könnte. (Hamm, 15.05.2018)

http://dachverband-sucht.de/wp-content/uploads/2016/11/positionspapier_clearingstelle_diamorphin.pdf

Heroin - Drugs and Lactation Database 

Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-.

Last Revision: May 1, 2018.

https://www.ncbi.nlm.nih.gov/books/NBK500783/

‘Heroin on Trial’: Heroin-Assisted Treatment in the UK ( A summary of the conference, 31.05.2018, London)

Speakers include: James Bell, Sarah Byford, Eilish Gilvarry, Carole Hunter, Brian Kidd, Beau Kilmer, Tim Leighton, Nicola Metrebian, Martin Mitcheson, Louise Sell, John Strang, Basak Tas, Ambros Uchtenhagen and Rob VanderWaal.

Including sessions on:

The ‘Old British System’ - overview and examination of long-term patients

The new system of ‘Heroin-Assisted Treatment’ and considerations in the UK

The UK-RIOTT trial and its findings

Heroin as treatment - current challenges and options

(SSA – Society fort he Study of Addiction, UK, Juli 2018)

https://www.addiction-ssa.org/commentary/heroin-on-trial-a-1-day-conference

Heroin Maintenance for Persons with Chronic Heroin Dependence [Internet].

Dalsbø TK, Steiro AK, Hammerstrøm KT, Smedslund G.

Oslo, Norway: Knowledge Centre for the Health Services at The Norwegian Institute of Public Health (NIPH); 2010 Jun.

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0097755/

Norwegen. Norway to give free heroin to 400 addicts: report

Norway's government is to start providing free heroin to up to 400 hardened addicts as it pushes forward with its drug policy reforms. (The Local, Norwegen, 09.08.2018)

https://www.thelocal.no/20180809/norway-to-give-400-addicts-free-heroin

Heroingestützte Behandlung (HeGeBe)

FOSUMOS – Forum Suchtmedizin Ostschweiz, Themenseite

https://www.fosumos.ch/fosumos/index.php/de/heroin/diacetylmorphin-heroin/heroingestuetzte-behandlung

Niederlande. Dutch cut overdose deaths by dispensing pure heroin

AMSTERDAM, the Netherlands - On a quiet alley in east Amsterdam, a security guard stands watch outside a brick office building, which 75 men and women visit twice a day to smoke or shoot up government-funded heroin.

Public-health experts in the Netherlands say free distribution is one reason that drug-related deaths are far less common than in the United States. The program also has reduced crime and improved the quality of life for many users, according to Ellen van den Hoogen, who runs the clinic. (cleveland.com, USA, 15.07.2018)

https://www.cleveland.com/metro/index.ssf/2018/07/in_amsterdam_the_government_pr.html

Diamorphingestützte Behandlung in Deutschland

Adressen der Ambulanzen und Praxen, in denen die diamorphingestützte Behandlung angeboten wird

http://www.diamorphin-behandlung.de/

Employment and paid work among participants in a randomized controlled trial comparing diacetylmorphine and hydromorphone.

Nikoo M, Vogel M, Choi F, Song MJ, Burghardt J, Zafari Z, Tabi K, Frank A, Barbic S, Schütz C, Jang K, Krausz M.

Int J Drug Policy. 2018 Apr 12;57:18-24. doi: 10.1016/j.drugpo.2018.03.021.

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/29655955

Understanding Heroin Overdose: A Study of the Acute Respiratory Depressant Effects of Injected Pharmaceutical Heroin.

Jolley CJ, Bell J, Rafferty GF, Moxham J, Strang J (2015)

PLoS ONE 10(10): e0140995. https://doi.org/10.1371/journal.pone.0140995

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0140995

Diamorphine-Assisted Treatment

Methadone and buprenorphine are among the first-line responses to the treatment of opioid dependence, alongside psychosocial approaches. A large body of research evidence shows that this approach is effective at stabilising drug use and preventing associated health and social problems. However, a small but important minority of chronic heroin-dependent individuals repeatedly fail to benefit from this kind of intervention. This group often experience particularly severe health and social consequences, and effective treatment of these individuals therefore has the potential to have a large impact on the health costs associated with drug dependence. (SSA - Society for the Study of Addiction, UK, April 2018)
https://www.addiction-ssa.org/commentary/heroin-on-trial

Oral heroin in opioid-dependent patients: pharmacokinetic comparison of immediate and extended release tablets.

Perger L, Rentsch KM, Kullak-Ublick GA, Verotta D, Fattinger K.

Eur J Pharm Sci. 2009 Mar 2;36(4-5):421-32. doi: 10.1016/j.ejps.2008.11.008.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2753514/

Kanada. Feds ease restrictions on prescription heroin to address opioid epidemic

OTTAWA — Access to treatment for opioid addiction is about to get easier as the federal government promises changes to drug laws that would do away with some of the obstacles preventing doctors from offering prescription heroin and methadone. (Vancouver Sun, 26.03.2018)

http://vancouversun.com/pmn/news-pmn/canada-news-pmn/feds-ease-restrictions-on-prescription-heroin-to-address-opioid-epidemic/wcm/b121f646-9ccb-4194-a34f-716eaf62023b