Dr Roy Roberton FRCP, FRCGP, Reader, Department of Community Health Sciences, Edinburgh University, said:

"We have all been waiting for this study to be published - it is such a difficult area and this research shows that whilst none of the outcomes are close to achieving abstinence, treatment with supervised injectable heroin seems to be our best option.

"This is the intensive care for those heroin users who have failed after all sorts of other available treatments and continue to inject. These patients are familiar in every specialist clinic and are also known to GPs across the country. For most heroin users conventional treatments are very effective and the majority of patients manage to stop injecting on proper doses of oral methadone or buprenorphine but for those who can't stop injecting a more intensive, and inevitably expensive, intervention is needed. As with all specialist medical areas high quality treatments should be available in all regions for selected patients. Expansion of clinics providing injectable heroin will require similar levels of support to those provided in the trial to have the same chance of success and longer term observations of the progress of these patients will be an important follow up research requirement."