NAOMI: A Study to Compare Medically-prescribed Heroin With Oral Methadone in Chronic Opiate Addiction
Summary
The objective of this study is to determine whether the closely supervised provision of injectable, pharmaceutical-grade heroin (in combination with oral methadone) is more effective than methadone therapy alone in recruiting, retaining, and benefiting long-term heroin users who have not been helped by current standard treatment options.
Timeline
- Start
- 2005-03
- Primary completion
- 2007-04
- Completion
- 2009-04
Outcome
Met primary endpoint
paper rate of retention in addiction treatment in the diacetylmorphine group was 87.8%, as compared with 54.1% in the methadone group PMID 19692689 ↗
paper rate ratio for retention, 1.62; 95% confidence interval [CI], 1.35 to 1.95; P<0.001 PMID 19692689 ↗
paper The reduction in rates of illicit-drug use or other illegal activity was 67.0% in the diacetylmorphine group and 47.7% in the methadone group PMID 19692689 ↗
paper rate ratio, 1.40; 95% CI, 1.11 to 1.77; P=0.004 PMID 19692689 ↗
Publications
- Oviedo-Joekes E, Marchand K, Lock K, Chettiar J, Marsh DC, Brissette S, Anis AH, Schechter MT. A chance to stop and breathe: participants' experiences in the North American Opiate Medication Initiative clinical trial. Addict Sci Clin Pract. 2014 Sep 29;9(1):21. doi: 10.1186/1940-0640-9-21.
- Oviedo-Joekes E, Guh D, Marchand K, Marsh DC, Lock K, Brissette S, Anis AH, Schechter MT. Differential long-term outcomes for voluntary and involuntary transition from injection to oral opioid maintenance treatment. Subst Abuse Treat Prev Policy. 2014 Jun 8;9:23. doi: 10.1186/1747-597X-9-23.
- Marchand K, Oviedo-Joekes E, Guh D, Marsh DC, Brissette S, Schechter MT. Sex work involvement among women with long-term opioid injection drug dependence who enter opioid agonist treatment. Harm Reduct J. 2012 Jan 25;9:8. doi: 10.1186/1477-7517-9-8.
- Marchand KI, Oviedo-Joekes E, Guh D, Brissette S, Marsh DC, Schechter MT. Client satisfaction among participants in a randomized trial comparing oral methadone and injectable diacetylmorphine for long-term opioid-dependency. BMC Health Serv Res. 2011 Jul 26;11:174. doi: 10.1186/1472-6963-11-174.
- Oviedo-Joekes E, Brissette S, Marsh DC, Lauzon P, Guh D, Anis A, Schechter MT. Diacetylmorphine versus methadone for the treatment of opioid addiction. N Engl J Med. 2009 Aug 20;361(8):777-86. doi: 10.1056/NEJMoa0810635.
- Gartry CC, Oviedo-Joekes E, Laliberte N, Schechter MT. NAOMI: The trials and tribulations of implementing a heroin assisted treatment study in North America. Harm Reduct J. 2009 Jan 21;6:2. doi: 10.1186/1477-7517-6-2.
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Subject | Diacetylmorphine | Small molecule | — | Other |
| Comparator | Methadone | Other / unclassified | — | Oral |