Is Prescribed Heroin Cost Effective?

Methadone Maintenance Treatment (MMT), for heroin addicts, comes with considerable societal expenses. Thankfully, an alternative treatment that is more effective and more cost-effective may exist.

Diacetylmorphine, or medically prescribed heroin, has previously been proven as an effective alternative treatment for heroin addicts. However, cost was believed to be a limiting factor.

A new study shows that, in fact, diacetylmorphine treatment may be cheaper than MMT.

There are addiction treatment options available at no cost to you.

Aslam Anis, Ph.D., director of the Centre for Health Evaluation and Outcome Sciences at Providence Health Care (CHÉOS) and professor in the University of British Columbia's School of Population and Public Health, led the study.

The findings are derived from the North American Opiate Medication Initiative (NAOMI), the first trial of diacetylmorphine treatment in North America which spanned from 2005 to 2008. The researchers also used administrative drug data from British Columbia.

"NAOMI demonstrated that heroin-assisted therapy is a more effective treatment option than MMT, but now, thanks to this study, we can also confidently say that there are significant economic benefits of using this medication," says Anis.

The researchers used the data from NAOMI in a cost-effectiveness data analysis to compare the two treatments. They found that the lifetime societal cost of MMT is $1.14 million per person. Diacetylmorphine cost less, at $1.09 million per person.

They attribute the reduced costs to the greater effectiveness of the treatment, with more patients in treatment longer and relapsing less. They also predict a reduction in related criminal activity and lower overall healthcare costs for these individuals.

"The question I get most about heroin-assisted therapy is whether we can afford the increased direct costs of the treatment," says co-author Martin Schechter, Ph.D., a CHÉOS scientist and professor at UBC's School of Population and Public Health. "What this study shows is that the more appropriate question is whether we can afford not to."

The study was published March 12, 2012 in the Canadian Medical Association Journal and was a collaboration between CHÉOS, UBC, Université de Montréal and the Northern Ontario School of Medicine.