Heroin-Assisted Treatment (HAT) is a medically supervised treatment that prescribes pharmaceutical-grade heroin (diacetylmorphine) to individuals with severe opioid use disorders who have not responded well to other forms of treatment, such as methadone or buprenorphine. Patients receive 2-3 doses of injectable or inhalable heroin per day at a medical facility. Some programs also offer hydromorphone as an option.
HAT offers a legal and safe alternative to buying illicit and potentially harmful drugs on the street. It includes various harm reduction interventions, connects patients to substance use disorder treatment, medical services, and social support. Multiple studies have demonstrated the benefits of HAT, such as improved health, social functioning, quality of life, reduced use of illicit drugs, improved treatment retention, reduced crime, reduced demand in drug markets, and cost-effectiveness.
However, widespread stigmatization and lack of understanding about HAT pose significant barriers to its implementation in the United States. Challenges include regulatory and policy conditions that make it challenging for clinicians to prescribe controlled substances, as well as obstacles related to insurance coverage and pharmaceutical dispensing. Misconceptions about the potential for increased drug use and crime within the surrounding community are also unfounded. In fact, existing HAT facilities have not noted evidence of increased community drug use, initiation of injection drug use, or drug-related crime.
Heroin is a potent drug that society stigmatizes due to its links to illicit drug use and its destructive effects on individuals and communities. The research indicates that heroin-assisted therapy (HAT) is an effective treatment for severe opioid addiction. By stabilizing individuals, HAT reduces cravings and withdrawal symptoms, enabling them to improve their quality of life. HAT is particularly useful for individuals who have not responded well to other forms of opioid addiction treatment, such as methadone maintenance therapy.
While effective, HAT remains stigmatized due to misunderstandings about addiction and ignorance of the role of medication in treatment. It is crucial to understand that addiction is a chronic brain disease that necessitates a combination of medication and psychosocial support for effective treatment. Medication-assisted treatments, like HAT, save lives and are evidence-based and clinically effective.
We must recognize that opioid addiction can affect anyone regardless of age, gender, race, or socioeconomic status. Condemning addiction merely fosters further marginalization of already struggling individuals. To destigmatize HAT, we must launch public information campaigns and increase research and treatment programs’ funding. By promoting evidence-based treatments and reducing stigma, we can improve patients’ access to care and support their journey towards recovery.