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Prescribing Heroin Instead of Methadone. The Pros and Cons of Prescribed Heroin Treatment

Updated on November 11, 2008

A recent Canadian case study examined prescribing legal pharmaceutical heroin to addicts in need. The study authors gave heroin to long term chronic heroin addicts who had tried repeatedly over a period of many years to quit using, without success. The users were given clean heroin in a supervised setting 3 times a day.

The study authors say that the trial was a great success and that the users' health and well being increased dramatically under the prescribed drug protocol; and since the users no longer needed to spend all their time sourcing money for illicit drugs, they were able to participate much more readily in society (getting jobs etc.).

The mayor of Vancouver (the trial city) has responded enthusiastically in support of the concept of prescribed heroin. Many others remain skeptical and the issue is both very political and contentious.

Should we prescribe heroin to those that need it?

Here are some of the pros and cons


  • Prescribing heroin attracts people into treatment who are not attracted to treatments such as methadone. (Some people will not tolerate the side effects of methadone or buprenorphine, and some users find these drugs ineffective).
  • Users given prescribed heroin stay in treatments for longer
  • Giving users affordable and safe medical heroin reduces crime. It reduces the profits made in selling illicit drugs and reduces petty crimes associated with addiction and a constant need for drug-money.
  • Giving users medical grade heroin ensures a consistent purity and safety – which in turn greatly reduces the odds of overdose.
  • Having users inject under supervision further reduces the risks of overdose.
  • Having users inject under supervision (and without fear of legal repercussions) reduces HIV and Hep C transmission.
  • Retaining heroin users in "heroin treatment" enables health services workers to provide peripheral services to an often inaccessible population of users.


  • Giving people access to heroin may make them less likely to attempt treatments such as methadone or Suboxone.
  • People with unfettered access to heroin may be less likely to attempt cessation of use.
  • The continued use of injection as a delivery method is risky, even under supervision.

It remains a very controversial idea. Some argue that until further studies prove that prescribed heroin is as beneficial to addicts as it is to society (through reduced crime, HIV transmission etc.) that doctors will be unlikely to advocate its use.

Others argue that any legalization of hard drugs begins a slippery slope to dangerous full legalization and increased rates of use.

And still others argue that since no treatment seems effective for a core group of long time opiate users, anything that improves their quality or life and health while also benefiting society is a very positive thing.

What do you think about prescribing heroin?

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    • profile image


      6 years ago

      Subutex is not as hard as heroin to kick ,an heroin is not as hard as meth to kick. Anyhow you never get a free lunch from any drug comedown and the turkeys get worse as you get older .but don't give up,power to all tryn to kick the demon dust.I've been heroin free for 9months an life is so much better clean.

    • profile image


      6 years ago

      ^^^guy above

      what a load of rubbish you just posted. Methadone doesn't actually work as a cure or treatment at all in most cases, all it does is act as a rubbish alternative to heroin for addicts who want to avoid withdrawal or cravings.

      Not only that i am sure any drug treatment worker will tell you that most of the people on methadone use on top, i've been on methadone for over a year and although it helps stop cravings to a degree it hasn't put me anywhere closer to a life without opiates.Methadone is a crap but cheap medication to offer society that by no means has a good success rate.

      Although you made a couple of good points i cant believe your against the legalization of would stop nearly all of the crime, people wouldn't be getting locked up left right & center, addicts could to a degree get on with their lives without being tied up in scoring and getting cash, girls & guys wouldn't need to sell their bodies,families wouldn't be so torn apart, kids wouldn't be separated from parents, gang violence would be reduced, cartels would diminish.

      But most importantly even if it was legal, it doesn't mean everyone would suddenly want it, it wasn't the case when it was legal before and if it was legal tomorrow i'm sure most of society would shun it as a dirty drug

      However, for those of us still caught up in the addiction i do not see what is wrong with me going to a reputable buyer, instead of a gang to buy my gear...walking home with it without worrying about being locked up or mugged for it...not be paying a high price...buying a purer product and not supporting murder and criminal activity

    • profile image


      7 years ago

      This method of treatment already exsists in parts of the world. I am an addict who is currently on methadone and although it helps with the withdrawl and as some people say/believe the cravings, I myself find that methadone is just a way to avoid the life of struggling to get by without the sickness. But now, I have just gotten a job for the first time in over 2 years and because of the hours this job requires I will no longer be able to get to my clinic within the dosing hours. I also am allergic to suboxone and possibly subutex so that idea for help is out for me. I think, as controversal as this idea may be, that heroin injection clinics are a very good and sensable choice for this country. Not only would it allow me a larger time frame to get medicated but it allows for those of us who find that methadone, suboxone, or subutex an unsuitable solution to our problems, a new one that does. one that gives us both the medication we already know would work for us, and also an enviroment where we can truly be honest about our feelings and desires towards herion, where we can get the fix we are truly seeking, with provided counciling and medical treatment. I know that if i was on herion matinance versus methadone I could go and tell my counciler what's going on in my head and my emotions without worry that I'd screw up my treatment because this isn't really what I am looking for. People today use methadone and other opiate substitutes as a way to not have to be sick on the days where they can't afford to go out and buy street 'dope', but the days they can they can easily skip a dose or a pill for that day. If addicts in this country were given the choice to be on methadone, subs, or heroin for treatment I believe many who are struggling with the desires of their addiction despite opieod medication, would find a new honesty within themselves about where they are in their recovery, how ready they are to be done with opiates for good, and what other factors are effecting them in a life situation formaly blamed completely on poor decision making in their pasts. One can find negitives in any kind of medication treatment be it for opiate dependance or ADHD treatment, or anything else from A - Z, but the bottom line is that when there are potental positives in a way to help treat a person medically the choice should always be in the hands of the one that choice directly effects. Let addicts choose if heroin matinace would be beneficial or harmful to their treatment, they need to control their own treatment if it's ever going to work for anyone. I'm currently trying to find the answer to my work schedual problem and being on only 20mg (02.0 ml) of methadone right now I should be able to find a doctor who would perscribe my methadone to me in a 30 day supply of pills, but this is proving impossible. So what would be worse... going back to heroin so I could potentially keep this job, or having the government allow me to go to a heroin clinic where I can get what I need when I need and build my treatment around a normal daily schedual? I for one don't believe I should have to plan my life around methadone, methadone should be allowing me to build myself a LIFE!

    • Harry Santos profile image

      Harry Santos 

      7 years ago from Metro Manila, Philippines

      What an interesting Hub. I don't really know that much about heroin but I've seen the film Trainspotting? You seen this? haha

    • profile image

      brady c 

      8 years ago

      I think that sounds like junkie heaven:) I wanna go!

    • profile image

      9 years ago

      just read this, and having been a drug user and heroin addict and now on methadone i think it could be a good idea. i think that the screening process would definetly need to be very thorough and if this was possible then i think it could only be beneficial to the people who find that the heroin consumes every part of there life. if they could some how be shown that there is other things out there then i think it could be a good thing. of course with this there are going to be bad points but i think the worst thing for addicts is to be put on methadone indefinetly. i have way more medical concerns and problems that seem to be caused by the methadone and if i could go back i think i would have weened myself of heroin instead of going onto methadone. good luck to anyone who faces these or other problems in there lifes.

    • profile image

      Alan Salinas 

      9 years ago

      I think it is a great idea. This world is comprised of many different types of people and what works for some doesn't work for others. I hate that this opium poppy plant was put on this planet and a few people can forbid the use of it. I mean life is short and why can't some people not enjoy what God put here for us. I can not stand that I can not really expand my mind. What did they do just 100 years ago. It was there for any body to use. Now just cuz some people can't handle it then they have to impose their thinking on the rest of us.Who are they to be God?


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