The huge increase in heroin addiction leading to increase in Aids/HIV has made governments and institutions take drastic measures. The most common and controversial treatments include needle exchanges and condom use.

There is also the demand to make methadone available more freely. In a desperate situation desperate measures have to be taken but that cannot be the end in itself.

The medication that is well-suited for countries outside Europe and the US in naltrexone. This medication was specifically developed by US government to keep recently detoxified opioid patients from using heroin or similar drugs.

It is the only drug that is non-addicting, non-abusable and has no street value. It has been rejected on the grounds that the compliance is poor and the patient's don't like it.

Addiction, unlike other chronic diseases like asthma or diabetes, is different insofar as the patients being ambivalent about the problem. They would like to continue using drugs to get 'high' but not experience the negative consequences of legal, marital or employment problems.

Since naltrexone has no positive (high) effects when taken or no negative effects (withdrawal) when a dose it skipped, it has to be given in a very different context. The WHO guidelines for the treatment of tuberculosis are well-suited for naltrexone.

The patient must be required to take the medication under supervision three times a week. Incentives should be provided for patients ingesting the medications and sanctions for skipping a dose. Many heroin addicts live with their families. Involving the family in the administration of the medication and counseling significantly improves recovery.

Naltrexone is making a strong comeback in many countries including the US and this highly effective medication should not be overlooked as an important treatment option.

The writer is attached to the Assisted Recovery Centers of America .