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Heroin-assisted treatment (HAT) is a treatment for opioid dependency, typically for those with injectable heroin dependency, which consists of twice-daily dispensing of medical heroin.
In Norway, the treatment program started in 2022, and the five-year limited-time pilot project is now halfway through. In collaboration with partners from Oslo University Hospital, Helse Bergen, Aarhus University, and the user organization proLARNet, SERAF has been tasked with evaluating the pilot project. The midterm report has now been launched in both Norwegian and English.
Over the first two years of the project, nearly 100 patients have begun treatment in HAT at the two clinics. About 30 of the patients who started have since left HAT, and half have continued in conventional opioid agonist treatment (OAT), which is considered a positive result.
In the early phase of patient trajectories in HAT, satisfaction was high and patient expectations were elevated. Individuals who start in HAT have multiple vulnerabilities, including experience with limited access to money for food. Many have recently been incarcerated, have had unstable housing situations, and personal experience with non-lethal overdoses. In addition, the majority of HAT patients reported declines in both somatic and mental health.
Preliminary results from patients who remain in HAT over time show that they experience improvement, both in terms of somatic and mental health and reduced criminal activity.
The total number in HAT after two years is lower than what was anticipated during the planning phase. This can be explained by several factors. On the one hand, starting up the treatment took more time and resources than planned, and costs have increased since the planning period five years ago. Additionally, changes in conventional OAT, such as access to various types of medication, might have led to fewer individuals within the HAT target group feeling the need for this treatment, assuming they can achieve the desired effect in OAT with other medications.
Overall, the assessment is that HAT seems to attract a patient group that has previously been difficult to reach with conventional OAT. The patient population starting in HAT faces many challenges, including a significant burden of symptoms with both somatic and mental health issues. Nonetheless, it appears that the treatment provides the desired effect of improved health outcomes and less criminality, while the majority remain in treatment over time. More detailed and extensive analyses will be included in the final evaluation report, which is to be completed by the first half of 2026.