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News Release

July 18, 2005

Poly-Drug Treatment Should Be Tailored, Says Prof

Using data provided by heroin addicts who also use cocaine, a University of Guelph professor has discovered unexpected drug use behaviours that could open the doors to improved drug treatment and rehabilitation strategies.

By understanding how and why users take these drugs, Francesco Leri of the Department of Psychology believes treatment programs can be tailored to an individual’s needs and be more effective in helping to end drug use or reduce its harm.

“Half of the people who inject heroin on a regular basis also inject cocaine or smoke crack cocaine,” said Leri, who surveyed some 750 intravenous drug users recruited across Canada. According to the Canadian Addiction Survey, this country is home to roughly 269,000 injection drug users, the vast majority of whom are believed to inject heroin or cocaine or both.

His research reveals that patterns of heroin and cocaine co-use run contrary to the popularly held belief that these two drugs are used simultaneously in a mixture commonly known as a “speedball.”

According to Leri, heroin users generally inject the drug in six-hour intervals and use cocaine in a variety of patterns as a supplement to boost their high or to alleviate side-effects of heroin use and heroin withdrawal. “There is a regularity in what they do,” he said. “Heroin users are taking cocaine for different reasons, so treatment for these dually addicted individuals should be different as well.”

This shows a need to rethink standardized treatment programs, Leri said. Methadone — the most common pharmacological tool used to manage heroin addiction — is highly effective in reducing compulsive heroin use. Leri suggests that tailoring treatment to increase the amount of methadone given to these patients, or combining methadone maintenance with prescribed medical-grade heroin could control both heroin and cocaine addictions in dually addicted individuals.

In collaboration with researchers at Rockefeller University in New York, Leri has found evidence that high-dose methadone maintenance can normalize systems of neurotransmitters in the brain. Neurotransmitters which regulate important psychological functions responsible for cravings and relapse vulnerability – systems that seem to be altered by cocaine exposure.

Although this research was conducted on laboratory rats, the results suggest that methadone may not only help users overcome heroin addiction but may also help control cocaine addiction, improving the neurological alterations caused by cocaine abuse.

In addition, eliminating the stigma attached to illicit drug use and working to integrate users into medical and social systems are key to alleviating harm caused by drug abuse, said Leri. “There’s a lot of stigma associated with this and that’s a big problem because it makes it difficult for researchers to study these individuals properly.”

He added that many significant health and social consequences of intravenous drug use could be curbed as a result of addressing treatment needs more effectively. These include the spread of HIV/AIDS and hepatitis C as well as prostitution, drug trafficking, robbery and other profit-driven crimes people engage in to get money to feed their habit.

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