Pubdate: Tue, 31 Jan 2017
Source: Victoria Times-Colonist (CN BC)
Copyright: 2017 Times Colonist
Author: Dirk Meissner
Page: C1


Prescribing medicinal heroin to prevent overdose deaths might appear
to clash with common sense, but the provincial health officer in B.C.
is backing the idea because he says European-style drug treatment
programs work.

The arrival of the powerful opioid fentanyl drove B.C.'s death toll to
a new peak last year of 914 overdose deaths, almost 80 per cent higher
than the 510 deaths recorded by the provincial coroner in 2015.

Dr. Perry Kendall said he wants support from colleagues in health care
and law enforcement to push the province to create treatment programs
that prescribe a pharmaceutical-grade version of heroin, called
diacetylmorphine. "It may be counterintuitive for people, but they
have been shown to improve functioning, improve physical health,
improve mental health," said Kendall. "They certainly get people out
of illegal drug markets and many of those people have gone on to have
relatively stable lives."

Treatment studies from Europe, where medicinal heroin started being
widely prescribed in the early 1990s, show declines in
illicit-drug-overdose deaths and disease rates linked to intravenous
drug use, including HIV, he said. Vancouver's Crosstown Clinic in the
Downtown Eastside is the only clinic in North America that provides
supervised medicinal heroin.

Dr. Michael Krausz, the University of British Columbia's Providence
health care leadership chair of addiction research, said people are
dying while next steps are debated rather than using the successful
blueprint from Europe. "I'm frustrated that things are so obvious and
we are waiting another month and another month," he said. "Every day
we are losing more young people."

Krausz helped start drug treatment projects in Europe, and much of his
work was done in Switzerland when it was gripped by a heroin-overdose
crisis similar to B.C.'s.

Krausz said Switzerland, followed by Germany, the Netherlands, Denmark
and other European countries, started drug-treatment programs that
included prescribed heroin, heroin substitutes and immediate detox and
counselling services. Drug-overdose deaths declined and lives were
changed and saved, he said.

"What you see is there is no overdose crisis in Zurich," said Krausz.
"There is no overdose crisis in Basil and there is no overdose crisis
in Berlin or Hamburg. The numbers did decline over the last decade,
where in some cities they are not even collecting or publishing numbers."

B.C.'s Centre on Substance Use is developing new guidelines for drug
treatment and prescribed heroin is part of that review, but more work
needs to be done, B.C. Health Minister Terry Lake said. "People tell
me: 'Yes, you should just do it,' but you have to be careful of any
potential unintended consequences," said Lake, adding if he gets
evidence to support the plan, he will follow through.
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