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Impact of an 18-Month, NHS-Based, Treatment Exposure for Heroin Dependence: Results from the London Area Treat 2000 Study

Authors

  • Fabrizio Schifano MD,

    1. School of Pharmacy, University of Hertfordshire, Hatfield, United Kingdom
    2. National Programme on Substance Abuse Deaths (np-SAD), International Centre for Drug Policy, St George's, University of London, London, United Kingdom
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  • Giovanni Martinotti MD, PhD,

    1. Department of Neuroscience and Imaging, University G.d’Annunzio, Rome, Italy
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  • Anna Cunniff PhD,

    1. International Primary Care and Cancer Research Group, University of Edinburgh, Edinburgh, Scotland
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  • Volker Reissner MD,

    1. Addiction Research Group, Department of Psychiatry and Psychotherapy, Rhine State Hospital, University of Duisburg-Essen, Essen, Germany
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  • Norbert Scherbaum MD,

    1. Addiction Research Group, Department of Psychiatry and Psychotherapy, Rhine State Hospital, University of Duisburg-Essen, Essen, Germany
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  • Hamid Ghodse MD, PhD

    1. National Programme on Substance Abuse Deaths (np-SAD), International Centre for Drug Policy, St George's, University of London, London, United Kingdom
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Dr. Martinotti, Clinica Villa Maria Pia, Via del Forte Trionfale 36, Rome 00135, Italy. E-mail: giovanni.martinotti@gmail.com.

Abstract

We set out to examine the impact of treatment for heroin dependence on drug use, injecting behavior, health problems, criminality, and physical and mental health over 18 months among heroin-dependent Londoners. A total of 100 heroin users were recruited for this longitudinal prospective cohort study with repeated measures (T0 as baseline, T1 after 9 months, and T2 after 18 months). The psychiatric evaluation and assessment of drug abuse levels were determined by the CIDI and the EuropASI. Additional evaluations included the WHO-DAS II for disability assessment and the UCLA-SSI for social support. The number of days of heroin use in the 30 days previous to each single assessment significantly reduced over time (p < .001). Similar reduction levels were observed for cocaine (p < .05), benzodiazepines (p < .001), and polydrug abuse (p < .001), but not for cannabis and alcohol. The number of injecting occasions reduced in parallel, with increase in days in work and reduction of money spent for drug acquisition activities and money obtained from criminal/illegal activities. The number of subjects experiencing suicidal ideation reduced over time (p < .05). In line with previous suggestions, significant reductions in drug use, criminality, psychopathology, and injecting behavior following treatment exposure for heroin dependence were observed. It is, however, of concern that alcohol and cannabis misuse levels remained unchanged. (Am J Addict 2012;21:268–273)

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