P-52SLOW-RELEASE ORAL MORPHINE (SROM) AS FURTHER MEDICATION IN OPIOID SUBTITUTION TREATMENT (OST): RESULTS FROM A REGISTRATION STUDY

Since 50 years oral methadone is the gold standard in OST. However, some of the heroin dependent patients refrain from this kind of treatment due to different reasons (e.g. no injections, limited well-being, excessive sweating). Additionally the prolongation of the QTc poses a clinical problem in double diagnosed patients as many medications that are necessary in the treatment of these patients, add to the QTc prolongation. Unconfirmed reports from different countries suggested that SROM could be a useful addition to the in Switzerland already registered substitution medications methadone, diamorphine, and buprenorphine. In order to test this assumption we conducted a prospective, multi-dose, open label, non-inferiority, cross-over study in a bi-national, multicentre setting over 11 weeks, in which methadone and SROM were compared (ITT population n = 276). Beyond this time-point, the participants were observed another 25 weeks. Main results were: The proportion of heroin-positive urine samples and retention rates under SROM was equal to the ones under methadone. The mean QTc-interval under methadone was significantly longer than that under SROM. Higher treatment satisfaction, fewer cravings for heroin, and lower mental stress were reported by patients under SROM. More Details will be presented. SROM is now registered in Switzerland as an OST medicatio

OR07-4E-CIGS (VAPORIZERS): A PUBLIC HEALTH OPPORTUNITY THAT WILL BE MISSED?

The most dangerous and deadly form of tobacco consumption, burning and inhaling tobacco cigarettes, is still free. Total eradication will not be possible for many reasons. Cigarettes have the connotation of the free world and prohibition would not only affect and criminalise marginalised people but also well respected members of our societies. So any attempt to curb the cigarette smoking should be welcomed by all exponents of public health. The dangerousness of cigarettes stems from burning tobacco and thus inhaling numerous toxic ingredients. E-cigs avoid the toxic by-products vaporising the nicotine. The public debate on e-cigs is quite bizarre. Should they fall under tobacco or pharmaceutical laws or others? The arguments against e-cigs follow basically 2 lines. Firstly it is contended that 60mg of nicotine are lethal (e.g. in Tobacco Atlas). Nicotine can be lethal but only in doses of 0.5g-1g or more. Secondly it is said that vapouring paves the way to cigarette smoking, which has not been observed despite enormous growth of the e-cig market. Recently Swiss experts spoke out for allowing nicotine containing fluids in a Delphi study under regulations (e.g. no advertising). So far the sale of nicotine containing fluids is forbidden in Switzerlan

Harm reduction in Bern: from outreach to heroin maintenance.

In Switzerland, harm-reduction programs have the support of the national government and many localities, in congruence with much of the rest of Europe and in contrast with the United States, and take place in public settings. The threat of AIDS is recognized as the greater harm. This paper describes the overall national program and highlights the experience from one city; the program is noteworthy because it is aimed at gathering comparative data from controlled trials

Time series modeling of heroin and morphine drug action

Clinical observations and recent findings suggested different acceptance of morphine and heroin by intravenous drug users in opiate maintenance programs. We postulated that this is caused by differences in the perceived effects of these drugs, especially how desired and adverse effects of both drugs interacted

Pattern of regional cerebral blood-flow changes induced by acute heroin administration--a perfusion MRI study

Although both the subjective and physiological effects of abused psychotropic substances have been characterized, less is known about their effects on brain function. We examined the actions of intravenous diacetylmorphine (heroin), the most widely abused opioid, on regional cerebral blood flow (rCBF), as assessed by perfusion-weighted MR imaging (PWI) in a double-blind and placebo-controlled setting