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  1. SmokeTwibz

    In a North American first, heroin addicts in Vancouver will soon receive prescription heroin outside of a clinical trial.

    Doctors at the Providence Crosstown Clinic received shipment of the drug this week for 26 former trial participants and will begin administering the drugs next week. In all, 120 severely addicted people have received authorization from Health Canada to receive the drugs; the rest are expected to get them soon.

    This development comes after more than a year of battles between Vancouver doctors and federal Health Minister Rona Ambrose. Doctors who had been prescribing heroin within the trial sought authorization to continue prescribing it afterward to keep the addicts from illicit heroin use and associated harms. But in October, 2013, Ms. Ambrose objected to Health Canada’s approval of the treatment and introduced regulations to make prescribing the drug (chemical name diacetylmorphine) outside of a clinical trial illegal.

    Providence and five plaintiffs, represented by the Pivot Legal Society, launched a constitutional challenge and sought an injunction while the case is before the courts. After a three-day hearing in May, B.C. Supreme Court Chief Justice Christopher Hinkson granted the injunction, saying risks associated with severe heroin addiction “will be reduced if [the addicts] receive injectable diacetylmorphine treatment from Providence physicians.”

    David Byres, vice-president of Acute Clinical Programs at Providence Health Care, said it is “exciting” to be able to move forward with a course of action that has been proven effective in clinical trials not only in Canada, but around the world.

    “The patients are so desperate for treatment, so desperate to be able to no longer be addicted,” Mr. Byres said Friday. “It’s a great thing to be able to help them, and help with the addiction that has taken over their entire lives.”

    With prescription heroin, patients attend the clinic two or three times a day, at set times, to receive the pharmaceutical-grade drug and sterilized supplies with which to inject it. They then must sit in a lounge-like area for 20 minutes so nurses can monitor them for adverse effects.

    Several European studies have shown that for the small subsection of severe addicts who do not respond to repeated attempts at more common treatments, such as methadone, prescription heroin resulted in a reduction of illicit drug use and criminal activity and physical and mental health improvements. Employment satisfaction and social reintegration also improved.

    The 2005-2008 North American Opiate Medication Initiative (NAOMI), led by researchers from Providence and the University of British Columbia, produced the same results. A follow-up study by the same researchers called the Study to Assess Longer-term Opioid Medication Effectiveness (SALOME) seeks to find whether hydromorphone – a powerful but legal pain medication – is as effective a treatment as prescription heroin. The double-blind trials’ severely addicted 202 participants were split in half, with one half receiving hydromorphone and the other heroin.

    As participants cycled out of SALOME, some had stabilized enough so that methadone became a sufficient treatment. For the others, doctors applied to Health Canada to continue prescribing heroin outside of the trial, as it has already been proven effective and hydromorphone is still being studied. Health Canada sought the advice of an independent expert on opioid dependence and in September, 2013, began approving the trial doctors’ requests.

    Since Ms. Ambrose banned the use of prescription heroin in October, about 30 of the severely addicted patients have left the Providence doctors’ care, with some relapsing into illicit heroin use. However, the clinic is optimistic it can re-engage them, Mr. Byres said.

    Adrienne Smith, a health and drug policy lawyer with the Pivot Legal Society, said Pivot is looking forward to making arguments at trial about the plaintiffs’ constitutional rights to access life-saving treatments.

    “The minister made the decision to change the regulations preventing them from getting this medication based on ideology and not evidence,” Ms. Smith said. “The minister’s decision put the lives of heroin users in jeopardy.”

    November 22, 2014
    Andrea Woo | The Globe and Mail

    Author Bio

    My name is Jason Jones. I'm from Rochester, MN and I'm 35 years old. I scrap metal and work as grounds keeper at a local trailer park. In the winter, I shovel a bunch of driveways and sidewalks to make some extra money and to stay busy. In my free time, I try to find interesting articles about the war on drugs that I can post on Drugs-Forum, so that the information can reach a wider audience.


  1. supermono
    Does that mean lots of people will move to canada ? This is a difficult one. Whats to stop the addict who has had a shot of pure heroin going and scoring down the road and shooting up again ? I know they have used similar methods in Europe and I would like to see people get help but I dont know if this will work. Time will tell I suppose. I hope it does work. I really do.
  2. DeepGreenSea
    "What's to stop the addict from...shooting up again?"

    Nothing-except the addicts heartfelt desire to be clean. There is nothing to stop addicts from going to score street methadone after drinking their Foul Pink Potion...some do. Some eventually realize the futility of their behavior, realize that there ISN'T anyone to stop them. This wisdom nugget, hard won, allows them to stabilize, to use their Deep Pink in a constructive way...

    The people in this trial have literally tried and failed miserably on every possible opiate addiction treatment-at least twice. They WANT to be clean, because they know that they are very very close to death.

    I just wanted to clarify a little because I am a Huge Believer in Heroin Management, and know that many more people would be too if they had more perspective. I am also a believer in the use of heroin, clinically, as a pain reliever in palliative care! But that's a thought/thread!
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