heroinassisted

Heroin-assisted treatment (HAT), also called heroin-assisted treatment, is a medical approach to severe opioid use disorder in which pharmaceutical-grade diacetylmorphine (diamorphine, heroin) is prescribed and administered under supervision for patients who have not benefited from standard opioid agonist therapies such as methadone or buprenorphine.

In HAT programs, diacetylmorphine is typically provided as injectable diamorphine in a clinic setting, with dosing individualized and given under the supervision of healthcare staff. The program is usually integrated with other services including harm-reduction measures, medical care, addiction treatment, and psychosocial support. Because diacetylmorphine is a controlled substance, access is restricted to specialized clinics in jurisdictions that allow it; administration occurs within regulated protocols to prevent diversion and overdose.

Evidence from clinical studies and systematic reviews indicates that HAT can improve treatment retention and reduce illicit opioid use among patients who have not responded to other treatments. Some studies also report reductions in criminal activity and transmission of infectious diseases and improvements in overall physical and mental health. However, results vary by setting, and HAT remains controversial and is not widely available.

Geographically, HAT has been implemented mainly in a few countries in Europe, notably Switzerland, as well as other European jurisdictions and Canada; in the United States it is not broadly authorized. Program availability depends on national drug policy, regulatory approvals, and funding.

Related topics include opioid substitution therapy, diacetylmorphine, and harm reduction.