Pubdate: Fri, 24 Feb 2017
Source: Peace Arch News (CN BC)
Copyright: 2017 Peace Arch News
Author: Kevin Diakiw

Medical discussions


A public suggestion by the provincial coroner to provide heroin to
addicts is turning some heads.

The comments by chief coroner Lisa Lapointe last week came after it
was learned 116 people in this province died of overdoses from illicit
drugs in January.

It's widely believed the deaths are a result of fentanyl, a drug 100
times stronger than morphine.

Lapointe said the people who have died haven't been successful in a
variety of treatment programs.

"For these people, I think we would be wise to seriously consider the
carefully considered suggestion made by provincial health officer Dr.
Perry Kendall - the possibility of providing clean, medical-grade
heroin to that small subset of users for whom nothing else has
worked," Lapointe said.

Lapointe told Black Press Tuesday the fine details of delivery and
assessment would be largely up to the medical community, but it would
be administered to patients in a clinical setting.

Dr. Scott MacDonald at Crosstown Clinic in Vancouver has been
administering heroin since the middle of last year.

"He's managing about 130 patients," Lapointe said, adding he's doing
it quite successfully.

Prior to last year, there had been a ban on the use of pharmaceutical
heroin, but the federal government overturned that law.

Lapointe said use of medically prescribed heroin would be very

"For those who have been dependent for a lengthy period of time, and
all other treatment options have been tried and haven't worked, this
is an avenue to treat them," Lapointe said.

Dr. Ray Baker, a member of the National Recovery Advisory Council and
a South Surrey resident, isn't averse to the idea of using
pharmaceutical heroin for some patients.

"Is there a place of heroin-assisted treatment? Yes," Baker said in an
interview from Ottawa. "It's a tiny place, but we should be doing a
lot of other things concurrently or first."

There aren't enough resources aimed at recovery-based care, he

"To maintain people on an opiate when they're not properly selected is
a tragedy," said Baker, a leading expert in addictions in B.C.

While he supports the efforts to save opiate users, he suggests that
people dying from alcohol abuse is much higher.

Lapointe doesn't disagree with that, but couldn't give an exact figure
of alcohol deaths, as the cause is usually something else that
contributes to fatalities, such as liver failure.

She said alcohol problems have to be tackled through education and

Baker said there's a place for harm reduction in B.C., but he said
it's time to get the other three pillars of effective recovery -
prevention, treatment and enforcement - securely in place.

He equates harm reduction to palliative care for cancer

"People say to me, 'Dr. Baker, do you believe in palliative care for
cancer?' " Baker said. "Should everyone be put on palliative care? I
say hell no. I say let's treat the heck out of it. And those that
can't get well, we'll put them on palliative care. But let's hope
that's a tiny number once we've got the treatment in place."

Surrey Mayor Linda Hepner said she's heard about legal heroin
treatment being discussed for some time, but noted this is the first
time she's heard it publicly recommended.

She isn't completely against it if it will save lives but, like Baker,
she said the end goal should be to get addicts completely off drugs.

All agree something substantive has to be done about the increasing
deaths among drug users.

"I've been told anecdotally that there is very little heroin on the
streets any more," Lapointe said. "Most of it is fentanyl."

She noted in November that the coroner's office created a Drug Deaths
Investigation Team which is now looking at every drug-related death in

The team's initial reports are expected to be made public in a couple
of months.
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