Two thirds heroin and crack cocaine addicts stop or significantly reduce use within six months of treatment
02 October 2009
The largest ever study of heroin and crack cocaine treatment programmes in England, led by Dr John Marsden, Institute of Psychiatry, King’s College London and researchers from the National Treatment Agency for Substance Misuse and colleagues, is published in the Lancet today. The research shows that in the first six months of treatment two thirds of both heroin addicts and crack addicts stop or significantly reduce use, however users of both drugs were less successful.
For every 1,000 people aged 15—64 years in England, around eight are heroin users and five crack cocaine users. Drug therapy with oral methadone (or buprenorphine) and supervised withdrawal, is the front-line community intervention for heroin addiction. Some heroin addicts also receive psychosocial therapy. As there are currently no substitute drug treatments for crack cocaine that have been proved effective, psychosocial treatment is the recommended treatment for crack cocaine.
The authors used data from the National Drug Treatment Monitoring System (NDTMS) to prepare their analysis, which was funded by the National Treatment Agency for Substance Misuse. The study involved more than 14,656 patients across England, with a heroin or crack cocaine addiction, or both, who received at least 6 months treatment.
The researchers found that of heroin users 42% stopped and 29% reduced their use and of crack cocaine users 57% stopped and 8% reduced use. A higher proportion of users of heroin only and of crack cocaine only abstained than did users of both, however the authors stress that people addicted to both drugs still did well (with over half either stopping or cutting down significantly after 6 months).
Dr John Marsden said: 'This is the largest study of the most commonly available drug treatments in England, and unequivocally concludes that present drug treatment for heroin and crack addiction is very effective in the first six months. In view of the chronic course of heroin and crack cocaine addictions, and the long-term care usually needed for treatment, our results are an important first indication of effectiveness for the English treatment system.'
He continues: 'Further studies are planned which build on the known benefits of drug treatment to increase understanding of how to enable more people to recover from addiction. New strategies are needed to treat individuals with combined heroin and crack cocaine addiction.'
Future studies will also focus on whether these changes in drug use are extended over longer periods, and the effectiveness of addiction treatment for other illicit drugs and alcohol.
A full copy of the paper can be viewed online at The Lancet: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61420-3/fulltext