Untreatable or just hard to treat? Results of randomised injectable opioid treatment trial (RIOTT)

The RIOTT (randomised injectable opioid therapy trial) project run by the Institute of Psychiatry in London presented an initial overview of its data at a conference this week. The trial compared treatments using optimised oral methadone, injectable methadone and injectable diamorphine (pharmaceutical heroin).

The clients came from a “hard-to-treat” population who had benefitted little from conventional oral methadone treatments. While all three trial treatments proved effective, the injectable heroin group made the greatest gains, especially in terms of the primary outcome measure of abstinence from street heroin. Clients also made notable gains in terms of reduction in crime and in health and social functioning. The trial director, Professor John Strang, said that the results were “quite spectacular” and called for wider availability of the treatment modality.

The RIOTT study adds to a growing and increasingly powerful evidence base for Heroin Assisted Treatment.