Prescription of heroin is less costly for society

Prescribing methadone plus heroin to chronic, treatment resistant addicts is less costly than methadone alone because it reduces criminal behaviour, finds a study in this weeks BMJ.

The study involved treatment resistant heroin addicts taking part in methadone maintenance programmes in six cities in the Netherlands. Prior to study entry, the heroin addicts frequently engaged in illegal activities to acquire money or drugs.

They were randomised to treatment with methadone plus heroin (experimental group) or with methadone alone (control group). After one year, data from 430 patients were analysed.

Co-prescription of heroin was associated with better quality of life measures. Although the costs of co-prescription were considerably higher, they were offset by lower costs of law enforcement and reduced costs of crime against property. The average total net savings amounted to 12,793 per patient per year.

From a societal perspective, supervised medical prescription of methadone plus heroin to chronic, treatment resistant addicts is very efficient.

Cost utility analysis of co-prescribed heroin compared with methadone maintenance treatment in heroin addicts in two randomised controlled trials.
http://bmj.com/cgi/content/full/330/7503/1297