Province won't fund long-term phase of controversial research
Some called them drug dealers. Others said they enabled a terrible habit.
But researchers in Montreal and Vancouver were vindicated when their controversial study showed giving pure heroin to hardcore heroin addicts was more effective than methadone to treat the addiction.
Now, as doctors prepare to launch a second phase of the groundbreaking medical trial, which they hope will lead to heroin becoming a permanent treatment option, Quebec has balked at funding the Montreal clinic, effectively stopping the research, the Star has learned.
The decision will have "disastrous consequences for people addicted to heroin and (who) don't respond to standard treatment," said Dr. Suzanne Brissette, head researcher in Montreal and chief of addiction medicine at Saint-Luc hospital. "There is no other treatment for these people."
Traditional methadone treatment had failed to help those recruited for the first study.
Had investigators found a treatment for cancer or diabetes, the government wouldn't think twice about funding it, Brissette said.
"It's a clear case of discrimination," she said. "We have a treatment that works and they're saying, `Sorry folks, you won't get it.'"
Doctors say the immediate goal of opiate addiction treatment isn't necessarily to stop drug use, but to stabilize the addict and move them toward a healthier lifestyle.
There are about 90,000 heroin addicts in Canada, experts say.
In the first study, 251 participants were either injected with heroin or given oral methadone over a year at specialized clinics.
The results, published in August in the New England Journal of Medicine, showed patients who received heroin were more likely to stay in treatment. As well, their use of street drugs dropped more.
In the summer, the researchers announced the Canadian Institutes of Health Research, a federal funding agency, had approved the three-year Study to Assess Long-term Opioid Maintenance Effectiveness.
Approval was conditional on local government funding.
While Vancouver authorities have indicated the clinic will be funded, Quebec's Ministry of Health and Social Services refused, citing the current economic climate.
Besides some public skepticism, there has also been opposition from addiction specialists.
"Injection heroin is the worst of all opiates," said Dr. Mel Kahan, medical director of the addiction medicine service at St. Joseph's Health Centre in Toronto. "It's not legal ... and it's not safe."
November 23, 2009