Central Committee on the Treatment of Heroin Addicts (CCBH), University Medical Center Utrecht, Utrecht, The Netherlands.
Drug Alcohol Depend. 2012 Jan 1;120(1-3):74-80. doi: 10.1016/j.drugalcdep.2011.06.025. Epub 2011 Jul 22.
To investigate in heroin-assisted treatment (HAT) compared to methadone maintenance treatment (MMT): the course of heroin craving and illicit heroin use, their mutual association, and their association with multi-domain treatment response.
RCTs on the efficacy of 12 months co-prescribed injectable or inhalable HAT compared to 12 months continued oral MMT.
Outpatient treatment in MMT- or specialized HAT-centers in the Netherlands.
Chronic, treatment-refractory heroin dependent patients (n=73). STUDY PARAMETERS: General craving for heroin (Obsessive Compulsive Drug Use Scale); self-reported illicit heroin use; multi-domain treatment response in physical, mental and social health and illicit drug use.
The course of heroin craving and illicit heroin use differed significantly, with strong reductions in HAT but not in MMT. General heroin craving was significantly related to illicit heroin use. Heroin craving was not and illicit heroin use was marginally related to multi-domain treatment response, but only in MMT and not in HAT.
Heroin craving and illicit heroin use were significantly associated and both strongly decreased in HAT but not in MMT. Craving was not related to multi-domain treatment response and illicit heroin use was marginally related to treatment response in MMT, but not in HAT. The latter was probably due to the strong reduction in illicit heroin use in most patients in HAT and the small sample size of the sub-study. It is hypothesized that the strong reductions in craving for heroin in HAT are related to the stable availability of prescribed, pharmaceutical grade heroin.
比较海洛因辅助治疗（HAT）与美沙酮维持治疗（MMT）：海洛因渴求的过程和非法海洛因使用，它们之间的相互关联，以及它们与多领域治疗反应的关联。
12 个月共开处方注射或吸入 HAT 与 12 个月继续口服 MMT 的疗效 RCTs。
荷兰 MMT 或专门的 HAT 中心的门诊治疗。
慢性、治疗难治性海洛因依赖患者（n=73）。
一般海洛因渴求（强迫性药物使用量表）；自我报告的非法海洛因使用；身体、心理和社会健康以及非法药物使用的多领域治疗反应。
海洛因渴求的过程和非法海洛因使用的过程有显著差异，HAT 显著减少，但 MMT 没有。一般海洛因渴求与非法海洛因使用显著相关。海洛因渴求与多领域治疗反应无关，而非法海洛因使用与多领域治疗反应仅在 MMT 中相关，而不在 HAT 中相关。
海洛因渴求与非法海洛因使用有显著的相关性，两者在 HAT 中都显著减少，但在 MMT 中没有。渴求与多领域治疗反应无关，非法海洛因使用与 MMT 中的治疗反应仅略有相关，但不在 HAT 中。后者可能是由于 HAT 中大多数患者非法海洛因使用量减少，以及子研究的样本量较小所致。假设 HAT 中对海洛因的强烈渴求减少与处方、药物级海洛因的稳定供应有关。
