[en] Background: Heroin-assisted treatment (HAT) can improve the condition of heroin addicts resistant to other treatment. A new trial compared HAT and methadone treatment with HAT limited to 12 months in order to assess its feasibility and efficacy in Belgium.
Methods: TADAM (Treatment Assisted by Diacetylmorphine) was an open label randomised controlled trial. The experimental treatment was based upon the Swiss model of HAT developed in 1994. The primary efficacy criterion was determined by an improvement in street heroin use or in (physical or mental) health or a decrease in criminal involvement. Participants were assessed every 3 months. Self-reported data were complemented with toxicological analyses and criminal proceedings.
Findings: 74 participants were randomised in the trial: 36 in the experimental group and 38 in the control group. The experimental group counted 30% of responders more than the control group at 3 months (p<0.05), 6 months (p<0.05), and 9 months (p<0.01). At 12 months, the number of responders was still higher in the experimental group (11%) but the difference was no longer significant (p=0.35). Street heroin use increased in the experimental group at the 12-month assessment just before the end of HAT.
Conclusion: HAT is feasible and effective. However, HAT should not have a predetermined duration for heroin users for which heroin addiction became a chronic relapsing disease.
Other data: In addition to the outcomes of the randomised controlled trial, the report contains other exploratory data and analysis: satisfaction of in treatment, criminological data, opinion of heroin users not included in the trial, opinion of caregivers and field workers (in the HAT centre, in the partner centres, and in other centres in the addiction field), impact of the HAT centre on its neighbourhood and a socio-economic evaluation.
Funding: The TADAM trial was funded at 80% by the Federal Minister of Social Affairs and Public Health. It was also funded the City and the University of Liège. [nl] Een vertaling in het Nederlands van het document met de samenvattingen is hieronder beschikbaar.
Research Center/Unit :
ULg - Université de Liège
Disciplines :
Public health, health care sciences & services Psychiatry Criminology
Author, co-author :
Demaret, Isabelle ; Université de Liège - ULiège > Département des sciences cliniques > Psychiatrie et psychologie médicale
Litran, Géraldine
Magoga, Cécile
Deblire, Clémence
Van Caillie, Didier ; Université de Liège - ULiège > HEC-Ecole de gestion : UER > Diagnostic et contrôle de l'entreprise
Lemaître, André ; Université de Liège - ULiège > Institut des sciences humaines et sociales > Criminologie
ANSSEAU, Marc ; Centre Hospitalier Universitaire de Liège - CHU > Psychiatrie et psychologie médicale
Other collaborator :
Quertemont, Etienne ; Université de Liège - ULiège > Département de Psychologie : cognition et comportement > Psychologie quantitative
DUBOIS, Nathalie ; Centre Hospitalier Universitaire de Liège - CHU > Toxicologie clinique
CHARLIER, Corinne ; Centre Hospitalier Universitaire de Liège - CHU > Toxicologie clinique
De Roubaix, Jérôme
Language :
French
Title :
Projet TADAM: RAPPORT FINAL 2007-2013
Alternative titles :
[en] TADAM trial: final report 2007-2013
Publication date :
November 2013
Publisher :
ULg - Université de Liège, Liège, Belgium
Number of pages :
970
Name of the research project :
Projet TADAM, un projet pilote de traitement assisté par diacétylmorphine
Funders :
SPF Santé publique - Service Public Fédéral Santé publique. Sécurité de la Chaîne alimentaire et Environnement ULiège - Université de Liège Liège - Ville de Liège
Commentary :
Les articles publiés sur le projet (constituant la section I de ce rapport) sont référencés séparément sur Orbi :
Demaret, I., Lemaitre, A., & Ansseau, M. (2013). [Heroin]. Rev Med Liege, 68(5-6), 287-293.
Demaret, I., Herné, P., Lemaître, A., & Ansseau, M. (2011). Feasibility assessment of heroin-assisted treatment in Liège, Belgium. Acta Psychiatrica Belgica, 111(1), 3-8.
Demaret, I., Lemaitre, A., & Ansseau, M. (2010). [Efficacy of the treatment assisted by diacetylmorphine (pharmaceutical heroin)]. Rev Med Liege, 65(12), 681-687.
Demaret, I., Lemaitre, A., & Ansseau, M. (2012). Staff concerns in heroin-assisted treatment centres. J Psychiatr Ment Health Nurs, 19(6), 563-567. doi: 10.1111/j.1365-2850.2011.01810.x
