A new scientific evidence base is emerging for the effectiveness of heroin (diamorphine) assisted treatment (HAT) as a second-line treatment for chronic heroin addicts for whom orthodox treatments repeatedly fail. Findings from six randomised trials (UK, Switzerland, the Netherlands, Germany, Spain, and Canada) undertaken over the last 15 years, comparing heroin treatment with conventional oral methadone treatment for treating the most entrenched heroin addicts, have all reported substantial benefits.  

All these trials studied heroin treatment delivered in new clinics open 365 days, in which all heroin doses are administered under strict medical supervision. This model ensures community safety and protection against diversion of supplies to the illicit market.  

The National Addiction Centre was commissioned by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) to write the first report on heroin assisted treatment (HAT) to bring together all the scientific evidence for HAT with an overview of the practice and challenges of providing this new innovation treatment.  The report was written in collaboration with international experts in heroin treatment from Switzerland, the Netherlands, Germany, Spain, Denmark and Canada (they have all established supervised heroin treatment services in their countries and, with the exception of Denmark, have evaluated the effectiveness and cost effectiveness of heroin treatment with other conventional drug treatments) and the Cochrane Group. 

The report was funded by the EMCDDA through Action on Addiction. 

This report has been published in the EMCDDA Insight series; No. 11 entitled “New heroin-assisted treatment - Recent evidence and current practices of supervised injectable heroin treatment in Europe and beyond”.