Pubdate: Sun, 28 May 2017
Source: Province, The (CN BC)
Copyright: 2017 Postmedia Network Inc.
Author: Camille Bains
Page: 25


European experts say facilities like Vancouver's Crosstown can save
lives, money in battling opioid crisis

Addiction experts from five European countries say their experience
with prescription heroin programs have provided overwhelming evidence
to suggest Canada should expand its one clinic to tackle the deadly
opioid crisis.

Researchers from the Netherlands, Denmark, Germany, Switzerland, the
United Kingdom and Canada held a symposium in Vancouver on Friday to
share lessons they've learned from multiple clinical trials and years
of treatment.

Wim van den Brink of the Netherlands told a news conference that some
European programs started as a way to deal with the public nuisance of
drug use but the medical health benefits improved people's quality of
life and saved money in the criminal justice system.

"There's so much experience locally and internationally, the efficacy
is so clear," said van den Brink, a professor of psychiatry and
addiction at the University of Amsterdam's Academic Medical Centre.

"I'm not sitting here with some kind of moral superiority that we did
it so wonderful. Politically, it wasn't primarily motivated by public
health issues."

Seventeen clinics provide supervised injectable and inhalable heroin
for about 800 chronically addicted patients in the Netherlands, he

The impetus for the gathering, organized by the School of Public
Health at the University of British Columbia, was an estimated 2,000
overdose deaths across the country just since 2016, many involving the
painkiller fentanyl.

Vancouver's Swiss-based Crosstown clinic is the only site in North
America that provides heroin treatment for people who have committed
to two or three supervised injections daily after failing at multiple
other interventions.

"Even from a medical perspective, this is a cheap treatment if you can
save so many lives," van den Brink said.

"The only thing is, do we think the lives of addicts are worth the
same thing as people with any other disease?"

Senior research fellow Nicola Metrebian, of the National Addiction
Centre at King's College London, said the United Kingdom government
funded four clinics providing injectable opioid treatment in 2012
based on evidence from a major clinical trial there and from
international research but the facilities were forced to close because
of a lack of funding.

"We are in a very similar position to you guys in Canada," she said of
evidence of effectiveness and lack of funding. "We are still trying to
get this into routine treatment."

Eugenia Oviedo-Joekes, an associate professor at the University of
British Columbia's School of Public Health, presented two major
Canadian studies that led to the opening of the Crosstown clinic.

The program that now provides heroin-assisted treatment to 95 patients
has a waiting list of up to 600 people and needs to be urgently
expanded, she said.

Oviedo-Joekes said people who are treated at Crosstown no longer use
opioids sold on the street, which are often cut with deadly fentanyl,
and get help from social workers with issues such as filling out
housing applications as part of a network of support.

Dr. Martin Schechter, who chaired the Vancouver symposium and has
extensive expertise in HIV research, said the federal government has
introduced several initiatives during the opioid epidemic, but
provinces have balked at paying for programs.

"We're hoping that people here across Canada will see that the sky did
not fall in Europe."

Schechter said evidence from two studies, in Canada and the
Netherlands, showed significant cost savings from treating patients
with various injectable forms of medication, including heroin.

"So to argue that we can't afford it is wrong. The question is whether
we can afford not to do it."
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