Feasibility research into the controlled availability of opioids, Volume 1

Abstract

Executive Summary: The results of a three month exploration of legal, ethical, political, medical and logistic issues lead us to the interim conclusion that it would be feasible to undertake a randomised controlled trial as a test of the policy of expanding the availability of heroin in a controlled fashion for the management of heroin dependent users in the ACT. There is evidence that the ACT community is willing to consider such a trial, but also that ACT police have significant concerns about its logistics and possible ill effects. The trial would compare oral methadone treatment with a program of expanded opioid availability, in which dependent individuals would be able to take intravenous, oral or smoked heroin and/or methadone under careful medical supervision. Volunteers would be subject to strict residential eligibility criteria and would need to agree to extensive medical tests and data collections. They would be randomly assigned either to methadone treatment or to the expanded availability program. The two groups would be carefully followed for at least one year in an effort to discover whether or not the expanded availability program provides benefits for dependent drug users, their families and to society at large which methadone programs cannot provide. The purpose of the study would be to discover whether or not a policy of controlled heroin availability could ameliorate the massive burden which illegal heroin use currently imposes on Australian and ACT societies. Our exploration of these matters leads us to recommend to the Select Committee on HIV, Illegal Drugs and Prostitution of the ACT Legislative Assembly that it cautiously proceeds to a second stage exploration of the feasibility of such a study without commitment to the trial until logistic issues are more fully described.