Vancouver to offer free heroin.

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Vancouver to offer free heroin.

 

 

 

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Vancouver Plans To Offer

Free Heroin To Addicts

By Jane Armstrong

The Globe and Mail

1-31-5

 

VANCOUVER -- On a warm, rainy Saturday morning, Debbie Woelke stops

pushing her shopping cart long enough to discuss the pros and cons of a

plan to give free heroin to drug addicts in Canada's poorest

neighbourhood. The heroin trial is all the talk of Vancouver's Downtown

Eastside and Ms. Woelke, 48, thinks it's a good idea. She might even

apply, herself. " They should have done this a long time ago, " she said

leaning on her cart, which contains all her worldly belongings -- not

groceries.

 

Like other addicts, Ms. Woelke lives in a bleak rented room in a

residential hotel. Far better to be outside in the rain, even if it means

wheeling around your clothes all day.

 

" Sometimes you need something just to relax and get your mind together,

instead of always being in a state of panic. That's what's killing

everyone down here, " she said, pointing to the throngs of bedraggled

souls shuffling along East Hastings Street. Like Ms. Woelke, they must

hit the pavement every day to raise enough cash for their drugs. Most

steal. Many women work as prostitutes.

 

" They have to do things they wouldn't normally do. "

 

This is exactly what some of Canada's top addiction experts want to find

out when they begin the first heroin prescription trial in North America.

 

 

If heroin addicts are freed of their daily chase for drugs, if it is

given to them three times a day like medicine, can they change their

lives for the better?

 

In a couple of weeks, the research team will begin taking applications

here in Vancouver and later in Toronto and Montreal from addicts who want

to be part of the study.

 

Researchers are looking for hard-core addicts, people who have tried and

failed at least twice to get clean. In the three cities, there are spots

for 428 addicts, roughly half of whom will receive heroin for a year; the

other half will receive methadone, an artificial opiate that controls the

cravings for heroin.

 

In Vancouver, the trials are causing a stir on the syringe-littered

streets of the city's skid row, home to more than 4,000 drug users. Among

those who deal first hand with these chaotic lives, there's a feeling

that Canada is breaking new ground in how it treats the most intractable

of drug addictions.

 

Similar studies in the Netherlands and Switzerland have shown positive

results for addicts.

 

" What if you could say to an addict, 'For the next little while, you're

not going to have to get your drugs from Al Capone. You can get your

drugs from Marcus Welby,' " said Dr. Martin Schechter, the project's lead

researcher.

 

" You don't have to worry about this afternoon and this evening. And

therefore, you don't have to go and break in to cars or be a prostitute.

You could actually come and talk to a counsellor or . . . get some skills

training. "

 

It's a landmark study in North America, one that turns its back on

abstinence as the goal.

 

But not everyone is thrilled with the prospect of free heroin for

hard-core addicts. And even supporters have expressed concern about the

ethics of offering heroin to addicts for a prescribed period of time. Is

it fair to yank away their heroin at the end of the year?

 

Addiction experts in Canada have already expressed concerns about the

risk of overdoses.

 

Last December, two staff physicians at Toronto's Centre for Addiction and

Mental Health wrote scathing critiques to the ethics adviser of the

Canadian Institutes of Health Research, the agency funding the study.

 

Vancouver physician Stanley deVlaming is worried the trials are designed

to garner positive results. In Vancouver, 88 subjects are to receive

heroin, while 70 will receive methadone, the heroin substitute.

 

" How meaningful will it be to compare the group of 88 elated subjects

that win the heroin lottery to the group of 70 who were also desperately

trying to get the free heroin, but lost the luck of the draw? " asked Dr.

deVlaming, who has treated addicts in the Downtown Eastside for more than

a dozen years.

 

" The first group would likely be very motivated to give the researchers

positive results, while the second disappointed and disgruntled group

randomized to methadone would be much less motivated. "

 

As expected, the plan has rankled U.S. drug officials, specifically the

office of White House drug czar John Walters, where an official called it

an unethical and " inhumane medical experiment. "

 

Offering free heroin to addicts when there are proven treatments for

addiction can't be justified if the addict's desire is to get off drugs,

policy analyst David Murray said.

 

" What you're doing is making it easier to be a heroin addict, " he said

from Washington. " These people won't get that much better in the long

run. They will still be heroin addicts. "

 

Washington's disapproval was expected and hasn't deterred Ottawa from

funding the study. The Canadian Institutes of Health Research has

committed $8.1-million for the trials.

 

In Vancouver, the plan has the support of top politicians and law

enforcers, including the mayor and the police chief.

 

Mayor Larry Campbell, who was once a coroner and drug cop, said the

trials are needed because current treatments aren't working for hard-core

addicts.

 

" The critical thing is to accept this as a medical condition, " Mr.

Campbell said.

 

" The side effects of this medical condition is that it forces you to . .

.. do things that you would never do, be it work as a sex-trade worker, be

a B and E [break-and-enter] artist or a purse snatcher. So if I can

mitigate that by putting you on heroin, imagine the changes you could

have. "

 

Right now, the trial is waiting for Health Canada to grant the necessary

exemption form the Canadian Narcotics Act.

 

Ms. Woelke said she plans to tell her friends to apply. She would be

content to get on the methadone program.

 

" Methadone, whatever, " she said shrugging her shoulders. " I need

something every day. "

 

© Copyright 2005 Bell Globemedia Publishing Inc. .

 

http://www.theglobeandmail.com

 

 

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