Long-term effects of heroin-assisted treatment in Germany

Addiction. 2008 Jun;103(6):960-6; discussion 967-8. doi: 10.1111/j.1360-0443.2008.02185.x. Epub 2008 Apr 16.


Aims: Trials in Switzerland, the Netherlands and Spain have found that heroin-assisted treatment (HAT) as maintenance treatment for opioid-dependent patients reduces illicit drug use. A German trial also found diamorphine treatment to be superior to methadone treatment. The present study describes the association between 2 years of heroin treatment and improvements in health and social stabilization, as well as illicit drug use.

Design: A prospective cohort study design.

Participants: A total of 515 patients were assigned to diamorphine treatment; 278 patients remained in the study treatment for the entire period of 24 months (54.8%).

Measurements: The results on physical (Opiate Treatment Index Health Symptoms Scale) and mental (Symptom Checklist 90-Revised Global Severity Index) health and illicit drug use (number of days with drug use within the last month-European Addiction Severity Index) were examined by repeated-measures analyses.

Findings: Symptoms of physical (Pillai's trace = 0.837, df = 4, P < 0.001) and mental health (Pillai's trace = 0.450, df = 4, P < 0.001) improved during treatment. Street heroin use declined rapidly (Pillai's trace = 0.836, df = 4, P < 0.001), as did cocaine use (Pillai's trace = 0.280, df = 4, P < 0.001).

Conclusions: HAT is associated with improvements in mental and physical health in the long term.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesics, Opioid / therapeutic use*
  • Female
  • Germany
  • Heroin / therapeutic use*
  • Heroin Dependence / rehabilitation*
  • Humans
  • Male
  • Methadone / therapeutic use*
  • Substance Abuse Treatment Centers / methods*
  • Time
  • Treatment Outcome


  • Analgesics, Opioid
  • Heroin
  • Methadone