LONDON - Homeless drug users in Scotland will be allowed to inject pharmaceutical-grade heroin twice a day under the supervision of medical officials as part of a new program intended to reduce drug deaths and H.I.V. infection.

From 9 a.m. to 5 p.m. seven days a week, a $1.5 million facility in Glasgow that opened on Tuesday will allow a handful of drug users to receive doses of the drug alongside other treatment for their physical and psychological health, according to Glasgow City Council.

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TORONTO - An aging construction worker arrived quietly in the building's basement, took his seat alongside three other men and struck his lighter below a cooker of synthetic heroin.

A woman, trained to intervene in case of an overdose, placed a mask over her face as his drug cooked and diluted beneath a jumping flame. He injected himself, grew still and then told of the loss of his wife who died alone in her room upstairs - an overdose that came just a few months before this social service nonprofit opened its doors for supervised injections.

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Studies show controlled drug use can reduce consumption of street drugs

As the opioid crisis rages on across North America, a number of recent studies are pointing to cannabis and prescription heroin as viable options in curbing the consumption of lethal street opiates, reducing long-term medical and policing costs and extending the lives of users.

An analysis of opioid prescriptions in the U.S.published on Monday by the American Medical Association showed a significant decrease in opioid prescriptions in states that have adopted some sort of cannabis legislation. Using data from 2010 to 2015, the analysis counted 3.7 million fewer daily doses of opioids prescribed in states that allow weed dispensaries, while states that allow only home cultivation saw a decrease of 1.8 million daily prescribed doses.

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Every morning, Kevin Thompson takes a short stroll from his apartment to the Crosstown Clinic, where he signs in, gets his prescription medicine, then sits in a small room and injects it before heading off to work.

He follows this routine up to three times a day and has done so virtually every day for more than a dozen years.

The medicine is diacetylmorphine, the medical term for prescription heroin.

"It saved my life. No question, it saved my life," Mr. Thompson, 47, says emphatically.

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The Taliban in Afghanistan is now running significant heroin production lines in the war-torn country to provide jihadists and insurgents with billions of dollars, western law enforcement officials

And much of that heroin is flowing into Canada.

"More than 90 per cent of all heroin consumed in the US is of Mexican origin. But in Canada more than 90 per cent of the heroin consumed is of Afghan origin," said William Brownfield, US Assistant Secretary for Drugs and Law Enforcement when addressing reporters in the Afghan capital Kabul recently.

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The deadly painkiller fentanyl, thrust under a spotlight by a rare warning by three health agenices and city police, isn't the only dangerous street drug raising eyebrows in London.

Heroin is also showing up, in levels-those who work with addicts say they haven't seen before.

One agency blames the spike on the province tightening the prescription drugs it covers under a program for people on social assistance and seniors, which has driven some users to heroin instead.

"I've never known it (heroin) here. Now it is," said Karen Burton, needle and syringe program coordinator at Regional HIV/AIDS Connection in London, whose work includes a drug needle exchange program. "Heroin is here and I don't see it disappearing anytime soon."

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VANCOUVER - 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 in the midst of a 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.

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Ottawa's health unit supports prescribing heroin to treat severe addicts and at least one treatment clinic is considering it as the city fights the rising rates of overdoses from it and similar opioid drugs.

"We really see it as more an extension of our opiate substitution therapy program than part of our supervised injection efforts," said Rob Boyd, the head of the drug-treatment programs at the Sandy Hill Community Health Centre on Rideau Street. Boyd has been leading the charge to add an injection site to the centre's existing methadone clinic.

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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.

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Re: "Is free heroin the best route?" editorial, Feb. 7.

Most certainly. After free needles are provided to citizens with diabetes, everyone gets free legal drugs that are prescribed by physicians, B.C. parks are properly funded, citizens on disability get drugs free, the E&N is fully funded so passenger trains again run, a Malahat bypass is built, highways are properly maintained, ferries are free for everyone who lives on Vancouver Island, etc.

Until then, no free heroin should even be considered. People need to be responsible for the consequences of their actions.

N.F. Jamieson

Campbell River

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The overdose crisis, especially in British Columbia, has become an issue of moral panic, and everyone is paying attention.

The B.C. Coroner's Report for 2016 revealed a shocking number of deaths from overdose - 914, which far surpassed previous records and is nearly three times the number of deaths from automobile collisions. This crisis impacts us all and it requires a radical shift in the ways all provinces provide health care.

Unfortunately, the human and financial toll continues to rise because we continue to view illicit substance use as a moral and criminal issue rather than the healthcare issue it is. As a health-care social worker on the front line, I am lending my voice to those with substance-use disorders, the ostracized and overlooked.

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Vancouver's Hedy Fry differs from the prime minister on where the national dialogue on fentanyl should go

In 1999, Dr. Hedy Fry flew to Switzerland to learn about how the European country had responded to a surge in drug-overdose deaths.

"I travelled around with the police," the Liberal MP for Vancouver Centre recounted in a telephone interview. If they found someone addicted to drugs who was injecting on the street, Fry continued, the police would stop and offer to take the individual to a clinic where there were a doctor and nurses.

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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."

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As of the end of November, 755 people had died of drug overdoses in B.C. Prescription heroin could greatly reduce this toll.

One of the principal reasons for the large number of overdose deaths has been the increasing presence of fentanyl, an opioid 100 times more powerful than heroin. Fentanyl is often substituted for, or added to, other illegal drugs.

A single envelope of pure fentanyl is enough to produce thousands of pills and tens of thousands of dollars in profit. One kilogram of fentanyl, which can be purchased online for less than $100,000, is enough to produce one million pills that can be sold for $20 each.

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Re: "Teen in suspected drug death 'honour student led astray,' " Dec. 27. As a retired psychologist, I'm trying to understand why so far this year about 755 human beings have died of overdoses in B.C.

I've observed that Grade "A" addicts live only to consume drugs such as fentanyl-laced heroin regardless of whether it might kill them. Many pay drug dealers with the proceeds of crime and leave a swath of victims, including those who love them, in their wake. Eventually, their self-destructive antics wear out those charged to help them, such as police, firefighters, paramedics, hospital staff, social workers and counsellors who eventually succumb to compassion fatigue. Though a courageous step, safe-injection sites appear to simply maintain this grisly status quo.

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Re: "New toxic drugs add to overdose crisis: coroner," Dec. 20. Is everyone involved in the management (or mismanagement) of this problem ignoring the one solution to this problem that has been effect in England for years?

It's called prescribed heroin for certified addicts. It has to be cheaper than all the emergency services that are being flung at it. It would certainly save lives. As yet, I haven't seen or heard of anyone in a position to effect change espousing the advantages of such a program. Surely it's worth a look.

Doug Oliver

Sooke

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Advisory Council on the Misuse of Drugs also suggests supervised injecting rooms to combat rising number of drug deaths

Heroin on prescription and supervised injecting rooms are among a range of measures that the government's drug advisers have suggested to reverse the UK's soaring numbers of drug deaths.

Responding to a sharp rise in the number of heroin-related deaths in recent years, the Advisory Council on the Misuse of Drugs said maintenance of drug treatment programmes was essential to prevent further increases.

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This Christmas, Dianne Tobin will celebrate one year free of heroin. It will be the longest she's remained off the drug in 40 years.

"It's been touchy at times, because I went down [in dosage] so fast," she told the Georgia Straight over coffee in the Downtown Eastside. "It was tough at first, going down so much at one time. But it was working for me."

Tobin owes her success at getting off street heroin to an unconventional therapy: since the winter of 2011, a doctor has prescribed her diacetylmorphine, or prescription heroin.

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Columnists Brent Stafford and Garth Mullins battle over the issues of the day.

The Duel

Prescription heroin for addiction treatment in B.C.? It's about time

As hundreds die from fentanyl overdoses, Health Canada has ended Harper's ban on prescription heroin. And it's about time.

There's a fatal overdose every 12 hours in B.C. Over the years, I've had to resuscitate four people and known dozens who've died.

For people deep in addiction, medical treatment with heroin is much safer than adulterated, often-lethal street drugs. It reduces harm to the community too.

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The Duel

This Week's Topic: Should prescription heroin be made available for addiction treatment in B.C.?

Why does the left always fall in favour of making drugs more widely available to society? Social conservatives are certainly not the ones clamouring to legalize marijuana, drown citizens in more booze or readily handout heroin. What is it about the left? The only conclusion one could come to is the left's political and social agendas are somehow advanced by promoting a dulled, inebriated and wasted constituency. This is how the left prefers its voters.

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