Hydromorphone as effective as diacetylmorphine for severe opioid use disorder

Injected hydromorphone is as effective as diacetylmorphine for long-term street heroin injectors who won't take oral opioid maintenance treatment, according to Canadian researchers.

Oral maintenance treatments such as methadone and buprenorphine are effective for many people who are dependent on opioids such as heroin. However, even when available, “an important minority of individuals with severe opioid use disorder are not attracted into or retained in such treatments,” and alternatives are “urgently required,” Dr. Eugenia Oviedo-Joekes, of Providence Health Care in Vancouver, British Columbia, and colleagues wrote in an article online April 6 in JAMA Psychiatry.

One alternative is injectable diacetylmorphine (the active ingredient in heroin), delivered under supervision. However, diacetylmorphine is not widely available for such use because of “regulatory or political reasons,” they noted.

Marilynn Larkin reports

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