By Alfa · Feb 21, 2005 · ·
  1. Alfa

    Vancouver Addicts Will Be Getting Government-Approved Fixes In A Controversial Research Project

    As well as helping addicts, advocates say it should reduce drug-related crime, Daniel Girard reports


    VANCOUVER--Phil Denbak will not yet allow himself to dream of a day when he has broken the grip of heroin, his almost constant companion for more than

    25 years.

    But he is upbeat about the latest move intended to try to improve the lives of hardcore addicts like him on Vancouver's downtown eastside: free heroin injections. Denbak, 49, is hoping to participate in North America's first prescription heroin trial, which begins here next month before expanding to Toronto and Montreal this spring.

    The idea behind the study, which got final approval from Health Canada this week, is to find out if providing addicts with their average three daily fixes will improve their quality of life by eliminating the need to pay for drugs through theft, prostitution or other crimes.

    If so, proponents say, then life will be better across the broader community as well with safer and cleaner streets and fewer tax dollars spent on hospitals, policing and the courts.

    Similar studies in Europe found addicts' lives improved and crime rates fell. Some users found jobs, many shot less heroin and others got into treatment or quit the drug outright.

    Denbak finds it hard to fathom getting clean, though he's tried numerous times. Still, the former house painter, who spends most of his time panhandling, collecting bottles and doing what he can to raise the $50 a day he needs to feed his habit, thinks this could help.

    "I'm not going to stop using," Denbak says matter-of-factly, his hollowed cheeks, haggard look and glassy eyes stark testimony of his addiction. "But if I don't have to spend all day getting money for my fix, then I might be able to be more constructive.

    "This is part of the solution, not part of the problem."

    The North American Opiate Medication Initiative, or NAOMI, is an $8.1 million project funded by the Canadian Institutes of Health Research, a federal agency. It will have 470 addicts at three sites; half of them will get pharmaceutical-grade heroin made in Europe, the others methadone, a drug taken orally to ease cravings and withdrawal.

    Those taking heroin will get injections under medical supervision at special clinics. They will get it for 12 months, then transfer over a three-month period into methadone-maintenance or other treatment programs.

    With recruitment and transition, the study will last up to two years.

    "Right now, these people are injecting contaminated heroin using dirty needles in unsanitary conditions and living a life where they have to commit crime and prostitution to pay for their next fix," says Dr. Martin Schechter of the University of British Columbia, the project's lead researcher. "We're seeing if we can break that cycle."

    Schechter stresses researchers will recruit for the study only "the most severe cases of heroin addiction for whom there are no other treatment options." Participants must be 25 or older, have been addicted to the drug for at least five years, including the past 12 months, and have unsuccessfully tried a methadone program at least twice before.

    While Schechter admits the hard-core addicts who will qualify for the study may represent less than one-quarter of the estimated 5,000 injection drug users on Vancouver's downtown eastside, they account for a disproportionate amount of crime and other problems associated with heroin addiction.

    "This is an acknowledgment that some people are going to continue using drugs whether we like it or not," he says. "The question is, do we treat them as criminals or as people suffering from a medical condition and try to work on getting them better."

    The NAOMI project is the latest attempt at liberalizing drug policies in the area, regarded as Canada's poorest neighbourhood. It's also the location of North America's first supervised safe-injection site, which opened in 2003, where addicts inject their own drugs under the watchful eye of medical staff who monitor for overdoses.

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    'This is part of the solution, not part of the problem'

    Phil Denbak, heroin addict

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    In Vancouver, the police, mayor and some area business organizations are supporting the study in the hope it will help reduce crime and better treat those seen in the past as untreatable.

    But critics say free heroin will mean addicts will take more of it or increase their use of other drugs such as crack cocaine and crystal meth, which many of them already abuse. The best way to address the problem is with more detox beds and other treatments, they say.

    Conservative MP Randy White (Abbotsford) calls the philosophy of the NAOMI project "totally flawed."

    "You can't stop crime by giving people the root cause of that crime," says White, the Conservative critic on drug strategy. "It just doesn't make sense.

    "Like it or not, to get off a drug you have to abstain from it."

    White, who notes a United Nations report rejects the contention that there were positive outcomes from a Swiss prescription heroin trial in the 1990s, calls this "another shot in the dark" to fight the burgeoning drug problem.

    Much better and more effective solutions would be to increase education, advertising, rehabilitation and police enforcement, he says.

    "We're off on this other tangent because we've thrown up our hands and said we can't do anything with these people," he says. "So, we put them off to the side and juice them up.

    "That's wrong."

    But Ann Livingston, project co-ordinator with the Vancouver Area Network of Drug Users, says while more treatment facilities and programs are needed, the prescription heroin scheme is another way "to treat addiction like an illness, not like a crime."

    With evidence in Europe that such programs have not only improved the lives of addicts but cut down on crime, they should have wide appeal across the community, she says.

    "Canadians would be very wise to push for this kind of intervention for addicts rather than what we currently do," Livingston says. "I'd venture almost 90 per cent of addicts down here have been charged with a criminal offence and it doesn't stop them using."

    Dr. Stanley de Vlaming, who has treated addicts in the downtown eastside for more than a decade, worries that the "high degree of anticipation and hype" among neighbourhood users about NAOMI will skew results in favour of prescribed heroin.

    "Addicts are acutely aware that their behaviours and responses during the study may also determine whether free heroin might be available after the study," he says.

    De Vlaming also calls the project "premature" because it focuses too much time, money and energy on less than 5 per cent of addicts who don't benefit from methadone. It could result in too many people being in very expensive heroin maintenance programs when they, and many others, could be treated by expanding methadone and other treatment, he says.

    But Phil Denbak knows methadone isn't the answer for him. He's tried it three times before and suffered from insomnia, constant chills and repeated nausea.

    So, for him, prescribed heroin is one of his only options.

    "I'd like to try and get my life back together," he says. "And I think this could help."

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  1. condo_pygmy
    I think free pharmaceutical grade heroin should be handed out to those who suffer from the ugly street life, day to day suffering. Lets compare Heroin to alcohol. Alcohol is Way more Damaging to the brain and body. Clean heroin doesn't cause wet brain or liver damage. Infact heroin doesn't cause any major issues. The only set back is the intense withdrawl. If it were to be handed out at clinics it would make alot of hard core users capable of day to day functioning. This would also drive away the black market. I say give the addicts their medicine, heroin doesn't make people violent but alchohol Does and i've seen it and read about it 100's of times. Most violent acts are fueled by boose and that's a Fact !!!
  2. Yeahsme
    I agree with this strategy, but I didnt know that not everybody can take methadone(i'm talking about the guy that said methadone made him sick). I know about 50 methadone users and never known anybody that it made sick. But if it does for that one guy, then there is obviously more that can't take it because it makes them sick. Unless he's lying which is improbable.

    I'm for the legalization of all drugs. Educate people and let them make their own choices.
  3. bcStoner420
    This is a good thing, I think it will help everyone affected by the addicts. I'm hoping this will clean up East Hastings street a little, man can that ever be an ugly site.

    I also agree this will do much more good than harm.
  4. condo_pygmy
    Any person that's done both heroin & methadone will choose pure heroin over methadone anyday !! (fact)
    Methadone masks heroin addiction, most methadone clinics are "Only in it for the money".
    Low dose methadone is one of the hardest drugs to kick, the withdrawls stay with you up to 3 weeks, slowly tappering down, compared to heroin withdrals lasting 4-7 days. Swim has heard people still having goose bumps after 6 months from high dose methadone.:eek:
    Methadone has been used for over 30 years in heroin treatment, the % of recovery is in the 3% range, that's not saying too much about it's success rate. Any opiate is rough coming off, but there's far better choices than methadone. Subutex has recently become the choice drug, but costs lots of money to get. Again it falls into the phrase were only in it for the money. Subutex should be handed out at every clinic FREE and handed out at pharmacies for very little money, this would be so the poorer addicts get a taste of sobriety.
  5. cz-one
    Diamorphine scripts are used now in some countries as a 'last stop saloon'option,for the hardcore iv user who's been resistant to all the other treatments,on top of recurrent jailtime,and being infected with hiv/hepatitis etc.,and in the majority of cases it brings some despreately needed stability into their lives,its just a shame that to get into these treatments you have to have spent some serious time fucking your life up to be considered,it should be used more than it is,here in the uk,out of the hundreds of thousand known addicts,the number receiving heroin scripts is something like 500 people,i feel it should be expanded to the homeless street addicts,as an enticement into them getting into programs so they can break out of the vicious circle that life entails.
  6. trueNorth
    This reply won't make me popular, but I don't believe the government should be in the addiction treatment business. Neither should it be in the 'drug war business'. My point is that most illicits should be legalized and sold with quality control in place. If you then choose addiction is it up to society(other people) to fund your addiction?
  7. Coconut
    I agree. This way, your doctor and your family/friends would be able to help you with your addiction, not the state.
  8. stoneinfocus
    th figures of the studies made should read, crimes fell to zero, 80% picked up a job, zero drug related deaths and zero HIV-new infections and some got clean.
  9. jerbles
    this is a damn good strategy. Unfortunatly, I don't think the U.S. will catch on for some time (if ever).

    Having been a "heroin addict" for six years now, a crime-free life is not an option for swim. Cash isn't easy to come by without committing a crime, and even a high-paying job ($4-500 a week) would only supply swim for about three days. Most of the jobs swim has had in the past bring in $250 a week tops, and unless swim has his medicine, he can't even go to work. So he's really only working for a decent, sick-free weekend (paid on friday, broke again on monday), provided he was able to make it to work every day.

    This is why most junkies don't have jobs. Why waste time working when you can be making (getting) money that day.
  10. Pino
    The life of addicts actually improves. At least from the ones I spoke too in Amsterdam (were they are running such a experiment). Some can even do some work, because they have less worries about getting a fix. They also are easier to reach by health professionals. One guy I spoke and drunk some coffee with had lived on the street for a couple of years, convicted for various crimes, and now he had a job, a home and contact with his family again. He even used less heroine, paradoxical as it sounds. Free seems to imply less in this case.

    I think it is a good idea. It is a shame, if this idea is turned down by the governments. Maybe at some point it should be selled to individuals as they make enough money and are reaching a certain point of wellfare.
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