A medical facility in Vancouver, Canada that is legally allowed to prescribe and supervise heroin use has successfully helped addicts to avoid jail time and an array of health issues—but it still faces an uphill battle for legality in Canada’s courts. As reported by the New York Times, Providence Health Care’s Crosstown Clinic, located in Vancouver’s Downtown Eastside, currently administers a prescribed dose of diacetylmorphine hydrochloride, the active ingredient in heroin, to 110 patients as part of a maintenance program for addicts that have not responded positively to replacement drugs like methadone.
To obtain the prescription, patients must have participated in two previous clinical trails—the NAOMI project (North American Opiate Medication Initiative) and SALOME (Study to Assess Longer-term Opioid Medication Effectiveness), both of which looked at diacetylmorphine as a more effective replacement for pharmaceutically prepared hydromorphone, or Dilaudid—and made two previous attempts with a replacement therapy like methadone.
The results of these studies show that individuals who used diacetylmorphine used street heroin on fewer occasions, and committed fewer criminal acts in pursuit of such drugs. Additional research showed that the cost of administering a replacement therapy to a single patient per year would cost about $27,000 (mostly in staff wages)—a significant drop from the $45,000 a year taxpayers were billed for policing, court and jail time, health care and petty crimes associated with unsupervised drug users.
“The advantage of substitution treatment is that they don’t have to engage in whatever behaviors they were engaged in previously to get their fix, whether it was organized crime, dealing, sex trade work,” Crosstown physician Dr. Scott MacDonald told the Vancouver Sun. “This allows them to escape the chaos of the street and have an orderly existence without the cycle of craving and withdrawal.” Even more significant is the 87.8% retention rate for patients enrolled in heroin maintenance programs.
But programs like the one at Crossroads are fighting to continue to provide safe and legally supervised injections. The Respect for Communities Act, introduced by the Conservative Party in 2013, and 2015’s Bill C-2, impedes the development of new sites and places numerous restrictions on existing sites already administering medical heroin. Patients from Crosstown and the Providence Health Care Society filed a case with the Supreme Court of British Columbia to block the act, and Crosstown was granted an injunction allowing it to continue to provide the drug to patients until the case is heard.
A court date for the challenge is set for October 2016. Supporters have viewed Health Minister Jane Philpott’s recent endorsement for Vancouver’s Insite, the first legal injection facility in North America, as a hopeful sign.
