This Just In: Heroin Addicts Like Heroin

A Canadian study reported in the New England Journal of Medicine this week found that "injectable diacetylmorphine was more effective than oral methadone" as "a treatment for chronic, relapsing opioid dependence." Specifically, "the rate of retention in addiction treatment in the diacetylmorphine group was 87.8%, as compared with 54.1% in the methadone group," while "the reduction in rates of illicit-drug use or other illegal activity was 67.0% in the diacetylmorphine group and 47.7% in the methadone group."

Stripped of the medicalese, what the researchers found is that if you give heroin addicts heroin, they will keep coming back for more. They will also be less likely to buy heroin on the street or commit crimes to support their habit. These findings, similar to the results of European studies, are not exactly surprising. The puzzling thing is that we're asked to pretend that heroin is a "treatment" for heroin addiction. "Study Backs Heroin to Treat Addiction," says the headline over a New York Times story that begins, "The safest and most effective treatment for hard-core heroin addicts who fail to control their habit using methadone or other treatments may be their drug of choice, in prescription form."

What the study actually shows is that the problems associated with heroin addiction are largely caused by prohibition, which creates a black market in which prices are artificially high, quality is unreliable, and obtaining the drug means risking arrest and associating with possibly violent criminals. The drug laws also encourage injection by making heroin much more expensive that it would otherwise be and foster unsanitary, disease-spreading injection practices by treating syringes and needles as illegal drug paraphernalia. When you take these dangers out of the equation, regular use of heroin is safe enough that it can qualify as a "treatment" dispensed by men in white coats. That rather startling fact should cause people to question not just current addiction treatment practices but the morality of trying to save people from themselves by making their lives miserable.

For more on "the surprising truth about heroin and addiction," see my June 2003 Reason article.