Pubdate: Thu, 30 Oct 2008
Source: Christian Science Monitor (US)
Copyright: 2008 The Christian Science Publishing Society
Contact: http://www.csmonitor.com/cgi-bin/encryptmail.pl?ID=CFF0C5E4
Website: http://www.csmonitor.com/
Details: http://www.mapinc.org/media/83
Author: Irwin Loy, Contributor to The Christian Science Monitor
Cited: The North American Opiate Medication Initiative 
http://www.naomistudy.ca/
Bookmark: http://www.mapinc.org/topic/NAOMI (North American Opiate 
Medication Initiative)
Bookmark: http://www.mapinc.org/find?131 (Heroin Maintenance)
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)
Bookmark: http://www.mapinc.org/topic/Downtown+Eastside

VANCOUVER STUDY CLAIMS BENEFITS TO PRESCRIBING HEROIN TO ADDICTS

But Critics Say the Efforts Amount to a Dangerous Step Toward Legalizing Drugs.

Vancouver, British Columbia - Every morning for a year, Rob Vincent 
walked into a clinic on the edge of Vancouver's roughest 
neighborhood, rolled up his sleeves and injected pharmaceutical heroin.

Each time, Mr. Vincent played the role of guinea pig in a 
controversial, three-year, government-funded experiment that 
supporters hope will change the face of addiction treatment in this 
picturesque but drug-riddled western port city.

The findings of the North American Opiate Medication Initiative, or 
NAOMI, were released here on Oct. 17 and the results, researchers 
say, are "remarkable."

"Heroin-assisted treatment (HAT) is very safe when done properly," 
Dr. Martin Schechter, NAOMI's principal investigator, said at a news 
conference held to announce the findings. "Our results show it to be 
very effective."

The study is the latest effort made by a city with a history of 
employing often counterintuitive methods of tackling its drug 
problem. But while advocates tout the study's results, critics say 
the efforts amount to nothing more than a band-aid solution and a 
dangerous step toward legalizing drugs.

Fluctuating levels of local and federal support could either 
undergird or derail the effort here, and, with heroin demand 
increasing worldwide, it's a debate other nations are monitoring.

How does the treatment work?

HAT targets chronic addicts who have repeatedly tried but failed to 
kick the addiction that consumes their lives and devours taxpayer 
dollars through hospital trips and policing costs.

Instead, they are given controlled doses of heroin in a supervised clinic.

Researchers believed it would allow addicts to reduce their overall 
drug use, participate in less crime, and stay in treatment longer.

"This is a group, frankly, that society has written off as being 
beyond help," says Dr. Schechter, the director of the University of 
British Columbia's School of Population and Public Health.

Vincent, the drug user, says that he tried to quit heroin seven or 
eight times before entering the NAOMI study.

But he was always pulled back by the persistent cravings that left him ill.

"It's not something that I would wish on anybody," says Vincent.

With doses of heroin given three times a day at the clinic, Vincent 
stopped spending his days and nights trawling for his next hit.

For the first time in years, he found part-time work, unloading 
shipping containers down at the city's port.

"I was actually able to live a normal life," says Vincent.

A majority of participants had comparable results, NAOMI researchers found.

After 12 months in the study, illicit heroin use fell by almost 70 percent.

The number of days participants said they spent being involved in 
"illegal activity" was halved, as was the reported amount of money 
spent on drugs.

And 88 percent of those treated with heroin remained in treatment for 
at least one year.

In a climate where the thought of prescribing heroin to addicts might 
make the federal government queasy, proponents still see offering the 
drug in a range of treatment programs as a realistic option.

"Many people believe that we need a different approach," says 
Vancouver Mayor Sam Sullivan, who wants to see a clinic set up "tomorrow."

Vancouver is home to a concentrated and very visible addiction 
problem that has shamed and confounded successive governments.

One local advocacy group estimates there are 5,000 injection drug 
users living in the 12-block neighborhood locals used to call skid 
row: the Downtown Eastside.

And with Vancouver set to become a specimen under the international 
microscope of the 2010 Winter Olympics, there is an added urgency to 
address the problem.

"I think that once the citizens realize how much crime is going down, 
how much the load on our health services is going down, how much 
cheaper it is for everyone, that there's going to be a demand for 
this kind of program," Mr. Sullivan says.

Critics Decry Slippery Slope

Yet others see the study's results as another wobbly step in the 
wrong direction.

"Giving drugs as a method of treatment is a bunch of nonsense," says 
Al Arsenault, a 27-year veteran of the Vancouver Police Department, 
now retired.

"These guys just don't get it. Drug addicts need the cure, not the poison."

Mr. Arsenault said he agrees with addiction specialists that a small 
group of addicts will not quit drugs. But he argues the focus should 
instead be on increasing treatment options for all drug users, not 
prescribing drugs to the chronic abusers.

"What they're doing is they want to legalize drugs, when there's not 
enough treatment centers available," Arsenault says. "That's totally backwards.

"You don't start there, substituting one drug for another to keep 
them chemically addled in the corner," he says.

But the study's researchers remain confident in their findings.

"Based on the evidence," says Schechter, "we could apply and we will 
apply to have heroin licensed." 
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