Heroin by prescription is already available in Switzerland, Germany, the UK, and Canada, probably a number of other countries. In some places, it is considered the standard of treatment for intractable heroin addiction that has failed other treatments repeatedly. This is not new; the idea has been floated around for about a century and used on-and-off, particularly in the UK. Methadone therapy is basically the same idea but substituting a different opioid due to the stigma associated with diamorphine. Hydromorphone is becoming popular lately for this too. When taken under medical supervision (most programs require the addict to come to a clinic daily for dispensing) the physical and social harms are considerably less than using street heroin. The lack of legal, personal and other chaos from always chasing after the next dose often lets people stabilize their lives and wean themselves off.

In one of the more thorough studies on this, in Germany about 15 years ago, almost 40% of participants had voluntarily weaned themselves off with slowly decreasing doses after two years. Nearly all had decreased their use of street drugs. Nearly all were housed, some 60% were employed. Most persons admitted to the program had been homeless and and all were unemployed at the start. The average duration of heroin use was more than 20 years.

That is a remarkable result. It led to Germany making maintenance therapy generally available for addicts. And it keeps being repeated. There's a large body of evidence supporting the slow self-guided taper for benzodiazepine addiction as well, and a small but growing body that suggests it may work for a great many kinds of various addictive drugs, including stimulants. If we minimize the social and economic chaos to the addict by simply giving them their drug, that give them the opportunity to choose to stop using it. It's an uncomfortable proposition, counterintuitive to some, but the study results are compelling and must be wrangled with.

>If that's your standard, it's already a failure. You are never going to "safely" allow heroin on the street. You're never going to "safely" allow children's playgrounds.

The rest of the world disagrees with your assessment.

https://drugpolicy.ca/our-work/issues/heroin-assisted-treatm...