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Treating heroin addiction: comparison of methadone therapy, hospital therapy without methadone, and therapeutic community.

AIM
To analyze the success of three different treatment modalities for heroin addiction: methadone therapy, hospital therapy without methadone, and therapeutic community.


METHODS
Ninety heroin addicts from the city of Split, Croatia, were systematically allocated to three groups, with 30 participants each, according to the addiction treatment modality they underwent or treatment that resulted in the longest abstinence. All participants were heroin addicts for at least 2 years before the treatment. The first group was treated by methadone, the second by hospital therapy, and the third in a therapeutic community. The criterion of the treatment success was minimum two-year heroin abstinence after therapy.


RESULTS
After methadone therapy, only a single participant abstained from heroin for more than 2 years, but continued to use soft drugs and alcohol. After hospital therapy, none of the participants abstained from heroin. After therapy in a therapeutic community, 9 participants abstained from heroin; 5 of them continued to use soft drugs and/or alcohol. There was a statistically significant relation between heroin abstinence and therapeutic method (chi-square=16.4236, p<0.001; Fisher's exact test=14.246, p<0.001).


CONCLUSION
Treating heroin addiction in a therapeutic community may be a better treatment modality than methadone or hospital therapy.