This article examines injectable Opioid Agonist Treatment (iOAT), in which patients suffering from long-term, treatment refractory opioid use disorder (OUD) are prescribed injectable diacetylmorphine, the active ingredient of heroin. While iOAT is part of the continuum of care for OUD in some European countries and in some parts of Canada, it is not an available treatment in the United States. We suggest that one reason for this situation is the belief that a genuine treatment for substance use disorder cannot prescribe the same substance as that used. We examine possible rationales for this belief by considering four combinations of views on the constitutive causal basis of substance use disorders and the definition of effective treatment. We show that all but one combination counts iOAT as a genuine treatment and that there are good reasons to reject the one that does not. Specifically, we claim that medical interventions, such as iOAT, that significantly reduce the severity of a disorder deserve to be categorized as effective treatments and regarded as such in practice.

中文翻译：

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药物使用障碍的治疗可以开出与所用药物相同的药物吗？可注射阿片类激动剂治疗案例。

本文研究了可注射阿片类药物激动剂治疗 (iOAT)，在该治疗中，患有长期难治性阿片类药物使用障碍 (OUD) 的患者被开具注射剂二乙酰吗啡，即海洛因的活性成分。虽然 iOAT 是一些欧洲国家和加拿大部分地区 OUD 连续护理的一部分，但它在美国不是一种可用的治疗方法。我们认为造成这种情况的一个原因是认为真正的药物使用障碍治疗不能开出与所用药物相同的药物。我们通过考虑关于物质使用障碍的构成性因果基础和有效治疗的定义的四种观点组合来研究这种信念的可能理由。我们表明，除了一种组合外，所有组合都将 iOAT 视为一种真正的治疗方法，并且有充分的理由拒绝那些不是的组合。具体而言，我们声称，显着降低疾病严重程度的医疗干预措施（例如 iOAT）应被归类为有效治疗方法，并在实践中被视为有效治疗方法。