Rehm and Fischer, in calling for what amounts to the legalising of heroin,1 have selected evidence to support their view. They did, however, not include the Cochrane review that concluded from randomised control trials that no definitive conclusions about the overall effectiveness of heroin trials are possible.2
The authors also seem to be unaware that heroin addicts continuously use other psychoactive drugs, and therefore simply by prescribing heroin all one is doing is treating that addiction rather than the addict, who is also likely to be experiencing severe emotional and mental problems. In prescribing heroin to heroin addicts one is instrumental in increasing the severity of the addiction. Would the authors recommend smoking for those with emphysema? Or alcohol for those with alcohol related liver disease?
Competing interests: Drug and alcohol recovery counsellor.
References
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