Heroin Maintenance Treatment - Are the Further Investigation Needed?

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The aim of this review is to give new emphasis to key aspects of the proposed treatment of drug addiction. Surveys for so called “second-line” treatment of drug addiction, with heroin (diacetylmorphine) as a pharmaceutical preparation, started since 1990, but this issue is becoming particularly popular in the last period. Drug addiction according to WHO and International Classification of Diseases (ICD10) is chronic, relapsing disease characterized by compulsive drug seeking and use despite harmful consequences as well as neurochemical and molecular changes in the brain. Drugs generate crime, violence and other social problems that are damaging society as a whole. Drug addiction is medical disorder to which contributes more factors and it is necessary to implement the treatment in multi disciplinary manner - from pharmacological, psychiatric, and social aspect. In recent periods studies are carrying out in several countries in the European region, to provide justification, with the scientific medical evidence, for use of heroin as a pharmaceutical dosage form, for treatment of drug addictions for previously unresponsive group. This review paper is focused on maintenance treatment with heroin, retention of the patients into treatment, whether the dose that is expected to be effective at the same time is safe, which organ (systems) are involved in eliminating the drug from the body, whether the injection is the best way for application of the drug. Purpose of this review paper is not to be supporter or opponent, but to inform, transparently to discuss all aspects and to set conclusions about this type of treatment, within national strategy context.

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