Journal of Urban Health

, Volume 84, Issue 4, pp 552–562 | Cite as

Heroin-assisted Treatment (HAT) a Decade Later: A Brief Update on Science and Politics

  • Benedikt FischerEmail author
  • Eugenia Oviedo-Joekes
  • Peter Blanken
  • Christian Haasen
  • Jürgen Rehm
  • Martin T. Schechter
  • John Strang
  • Wim van den Brink


Since the initial Swiss heroin-assisted treatment (HAT) study conducted in the mid-1990s, several other jurisdictions in Europe and North America have implemented HAT trials. All of these studies embrace the same goal—investigating the utility of medical heroin prescribing for problematic opioid users—yet are distinct in various key details. This paper briefly reviews (initiated or completed) studies and their main parameters, including primary research objectives, design, target populations, outcome measures, current status and—where available—key results. We conclude this overview with some final observations on a decade of intensive HAT research in the jurisdictions examined, including the suggestion that there is a mounting onus on the realm of politics to translate the—largely positive—data from completed HAT science into corresponding policy and programming in order to expand effective treatment options for the high-risk population of illicit opioid users.


Heroin-assisted treatment Science Politics Opioid dependence Clinical trials 


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Copyright information

© The New York Academy of Medicine 2007

Authors and Affiliations

  • Benedikt Fischer
    • 1
    • 2
    Email author
  • Eugenia Oviedo-Joekes
    • 1
    • 3
  • Peter Blanken
    • 4
  • Christian Haasen
    • 5
  • Jürgen Rehm
    • 2
    • 6
  • Martin T. Schechter
    • 7
  • John Strang
    • 8
    • 9
  • Wim van den Brink
    • 4
  1. 1.Centre for Addictions Research of British ColumbiaUniversity of VictoriaVictoriaCanada
  2. 2.Centre for Addiction and Mental HealthTorontoCanada
  3. 3.Andalusian School of Public HealthGranadaSpain
  4. 4.Central Committee on the Treatment of Heroin Addicts (CCBH)University Medical CentreUtrechtThe Netherlands
  5. 5.Center for Interdisciplinary Addiction ResearchUniversity Medical CenterEppendorfGermany
  6. 6.Research Institute on Public Health and AddictionsUniversity of ZurichZurichSwitzerland
  7. 7.British Columbia Centre for Excellence in HIV/AIDSSt. Paul’s Hospital, University of British ColumbiaVancouverCanada
  8. 8.National Addiction CentreInstitute of PsychiatryLondonUK
  9. 9.NHS Foundation TrustLondonUK

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