Clinic to Prescribe Heroin to Addicts

A clinic providing free heroin (search) to Vancouver addicts is to open later this month to see if prescribing the drug can help addicts who have failed in other treatment programs.

Similar projects have been scorned in the United States, seen as unethical or dangerous. There have been such studies in the Netherlands, Switzerland, Germany and Spain.

The 12-15 month trial is to determine if prescribed, pharmaceutical-grade heroin — in conjunction with methadone treatment (search) — is more effective than methadone alone in treating certain opiate-addicted people.

"We're trying to figure out whether we can reach out to those people with medically prescribed heroin," said Dr. Martin Schechter, principal investigator for The North American Opiate Medication Initiative (search).

The project also will be conducted in Toronto and Montreal, but is set to get under way in Vancouver first, following government approval — expected in about two weeks.

More than 4,000 drug addicts live near the clinic in Vancouver's impoverished Downtown Eastside, an area known for its street drug deals.

Schechter said the trial will not attract addicts from other areas because the 157 people selected to take part must have been addicted for at least five years.

Those in the project will go to the clinic three times a day. Nurses will supervise the injections. Seventy people will receive methadone; the rest will get heroin and methadone.

Some in the latter group will be given the heroin substitute hydromorphone. It is distinguishable from heroin so researchers can determine through urine analysis what percentage of participants are cheating by also using illegal heroin and thus skewing the results.

Participants will be monitored for a year after the trial to see if they relapse.

The project has scientific approval — and $6.4 million — from the Canadian Institutes of Health Research, a government agency, and the support of the University of British Columbia, the University of Toronto and the Universite de Montreal.

Several American cities had been considered for the project, but the idea was abandoned, Schechter said.

The U.S. government would not back a similar program, said David Murray of the White House Office of National Drug Control Policy in Washington, D.C. He said addiction should be treated as a disease to be cured.

"We do not acquiesce in cancer; we fight it," he said. "To acquiesce in various addictions seems to be a deeply troubling, ethical and governmental hazard."

Benedikt Fischer, an associate professor at the University of Toronto and a member of the Center for Addiction and Mental Health, disagreed.

"I know that from the United States, this often looks like a form of surrendering to addiction," said Fischer, who is also working on the Vancouver heroin project. "But quite the contrary, we see this as a potential way of bringing people" into treatment.

Very little heroin will be at the Vancouver site, and stringent security measures will be taken, Schechter said.

Part of the project is to attract users to a clinical setting where they can get other help to kick their habits and stabilize their lives.