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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

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

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

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 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

Heroingestützte Behandlung (HeGeBe)

FOSUMOS – Forum Suchtmedizin Ostschweiz, Themenseite

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

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

Diamorphingestützte Behandlung in Deutschland

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

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

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/

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

‘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

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/

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

Treatment effectiveness of injectable hydromorphone and diacetylmorphine for severe opioid use disorder and its relationship with gender in the SALOME clinical trial

Heather Palis, Lisbon Addictions 2017, Second European Conference on Addictive Behaviours and Dependencies, Lissabon, 24.-26.10.2017

http://www.emcdda.europa.eu/system/files/attachments/6833/11H00_2_Heather Palis.pptx

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

Schweiz. Heroingestützte Behandlung in der Schweiz - Resultate der Erhebung 2016

Hiltebrand, Damian; Dey, Michelle; Bolliger, Heidi; Schaub, Michael P

Zurich Open Repository and Archive, University of Zurich (ZORA), doi.org/10.5167/uzh-140487

http://www.zora.uzh.ch/id/eprint/140487/1/HeGeBe_2016_FINAL03082017.pdf

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

Heroin Assisted Treatment: the case for expanding uptake - Dr Alex Wodak puts forward the case to increase uptake of Heroin Assisted Treatment (“HAT”). 

HAT has now been evaluated in trials involving a combined total of over 1,500 subjects in seven countries (Switzerland, the Netherlands, Spain, Germany, Canada, the United Kingdom and Belgium).

The modern era HAT of began in Switzerland in 1994. HAT evolved from heroin maintenance, which had been developed in England decades earlier.  Heroin maintenance was evaluated in a trial compared to methadone maintenance with mixed results and published by Hartnoll, Mitcheson and colleagues in 1980. But HAT differed from heroin maintenance in a number of very important ways. HAT involves much higher doses of heroin, patients are involved in selecting their dose, intensive psychosocial assistance is provided, all doses are supervised by health professionals and only treatment refractory, severely heroin dependent subjects are included. (IDHDP, 30.10.2017)

http://idhdp.com/en/resources/news/august-2017/heroin-assisted-treatment-the-case-for-expanding-uptake.aspx

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

Kanada. Guidance for Injectable Opioid Agonist Treatment for Opioid Use Disorder

British Columbia, Ministry of Health and British Columbia Centre on Substance Abuse, 2101

http://www.bccsu.ca/wp-content/uploads/2017/10/BC-iOAT-Guidelines-10.2017.pdf

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

Why Australia should provide Heroin Assisted Treatment to severely dependent heroin users after all other treatment options haven’t worked.

Heroin Assisted Treatment involves supervising prescribed pharmaceutical heroin self-administration with intensive psycho-social help to a minority of people with severe heroin dependence who have not benefitted from multiple other treatments.

The signatories of this letter include senior clinicians and researchers, major health organisations , peer based organisations and people with long standing experience and expertise in the fields of law enforcement, drug policy and drug treatment. (Harm Reduction Australia, August 2017)

http://www.harmreductionaustralia.org.au/wp-content/uploads/2017/08/Heroin-Assisted-Treatment-Statement.pdf

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

Die diamorphingestützte Substitutionsbehandlung in Deutschland - Ein Überblick über die gegenwärtige Entwicklung des stark diskutierten Behandlungskonzeptes

Von Stud. iur. Christopher Bendek, Tübingen

HRRS - Onlinezeitschrift für Höchstrichterliche Rechtsprechung zum Strafrecht, Dezember 2016, 17. Jahrgang

https://www.hrr-strafrecht.de/hrr/archiv/16-12/index.php?sz=8

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

Supervised Injectable Heroin: A Clinical Perspective.

Bell J, Waal RV, Strang J.

Can J Psychiatry. 2017 Jul;62(7):451-456. doi: 10.1177/0706743716673966.

Abstract

http://journals.sagepub.com/doi/abs/10.1177/0706743716673966

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/

Synthetisches Heroin für Schwerstabhängige - das gibt es in Stuttgart seit drei Jahren. Ein Angebot, von dem die Stadt sagt, es sei "wichtig und sinnvoll". Zum Beispiel für Sina Vogtländer. Sie hat eine 20jährige Drogenkarriere hinter sich - mit vielen Abstürzen, mit Aufenthalten in der Psychiatrie, mit vergeblichen Versuchen, vom Heroin wegzukommen. Ihr Arzt, der Suchtmediziner Andreas Zslonai, leitet die Stuttgarter Einrichtung und sagt über Sina und seine anderen Patienten: "Das schaffen nur Leute, die auch was ändern wollen in ihrem Leben!" (SWR, 22.06.2017, Audio, 31:00)

https://www.swr.de/swr1/bw/programm/leute/vogtlaender-sina-und-dr/-/id=1895042/did=19698914/nid=1895042/9jibkx/index.html

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

Men's and women's response to treatment and perceptions of outcomes in a randomized controlled trial of injectable opioid assisted treatment for severe opioid use disorder.

Palis H, Marchand K, Guh D, Brissette S, Lock K, MacDonald S, Harrison S, Anis AH, Krausz M, Marsh DC, Schechter MT, Oviedo-Joekes E.

Subst Abuse Treat Prev Policy. 2017 May 19;12(1):25. doi: 10.1186/s13011-017-0110-9.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5437624/

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

Heroin on trial: systematic review and meta-analysis of randomised trials of diamorphine-prescribing as treatment for refractory heroin addiction†.

Strang J, Groshkova T, Uchtenhagen A, van den Brink W, Haasen C, Schechter MT, Lintzeris N, Bell J, Pirona A, Oviedo-Joekes E, Simon R, Metrebian N.

Br J Psychiatry. 2015 Jul;207(1):5-14. doi: 10.1192/bjp.bp.114.149195. Review.

http://bjp.rcpsych.org/content/207/1/5.long

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

Bonn. Die Bonner Drogenambulanz, oder genauer Diamorphin-Ambulanz, gibt es seit 15 Jahren. Das Modell habe sich in der Praxis eingespielt und bewährt, sind die Betreiber - die Caritas, das Diakonische Werk und die Uniklinik - überzeugt. (General-Anzeiger, 23.06.2017)

http://www.general-anzeiger-bonn.de/bonn/stadt-bonn/Striktes-Reglement-f%C3%BCr-Patienten-der-Bonner-Drogenambulanz-article3586930.html

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