Pubdate: Sat, 06 Dec 2014
Source: Economist, The (UK)
Copyright: 2014 The Economist Newspaper Limited

Drugs Policy In Canada


Legal Narcotics In A Liberal City

THE people queuing up at the Providence Crosstown Clinic are pioneers
of a sort. They are heroin addicts whose habits have resisted
conventional treatment. They hope to become the first in North America
to get their fixes legally as part of a treatment programme rather
than just for a clinical trial. "It's heroin that you know is good,"
says one addict waiting outside, who aspires to join the queue.

Some European countries, including Germany and Switzerland, prescribe
heroin for the most severe cases of addiction. Patients taking heroin
are less likely to use illicit drugs and drop out of treatment than
those who use methadone, a substitute. Vancouver's eagerness to follow
is not surprising. It has long had Canada's most liberal drug
policies, and it has a big problem. Addicts congregate in Downtown
Eastside, two derelict blocks right next to tourist attractions and
the financial district. In the late 1990s the city had the highest
rate of HIV infection outside sub-Saharan Africa.

Across the street from the Crosstown clinic is one where addicts can
take drugs they buy off the street under supervision of the health
authorities. But that does not guarantee safety. In October 31 people
fell ill from a bad batch of street heroin. The Crosstown clinic, by
contrast, is prescribing top-quality stuff-diacetylmorphine made in
Switzerland-to 120 people whose addictions are tenacious enough to
warrant the treatment.

The hope is that they will take safer drugs, lead more regular lives
and eventually move to methadone. For some, the alternative is "to
inject in an alley using heroin that they didn't know for certain
where it came from," said Scott MacDonald, a doctor at the clinic.
"This has become the only choice."

The federal government, which has jurisdiction over drugs policy,
disagrees. It wants to deny the exemption for research under which the
drugs are being administered. Giving addicts "the very drugs they are
addicted to" does not help them, says Rona Ambrose, the health
minister in the Conservative government. A group of addicts took the
matter to British Columbia's Supreme Court and won a judgment that to
withhold treatment might cause "irreparable" harm. The programme,
which had been interrupted, resumed on November 27th under the court's

But the ruling has force only until Canada's Supreme Court weighs in
on the case, which is expected to happen in 2016. Until then, addicts
will find relief at the Crosstown clinic up to three times a day. One
woman has been trying to break the habit for nine years but the
struggle feels as if it has been going on "for 90 years at least". For
a while, that struggle will be a bit safer.  
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