VANCOUVER SET TO EXTEND HELP FOR ADDICTS

Pilot Project To Use Legally Dispensed Drugs

VANCOUVER -- There is already a free needle exchange, a methadone
maintenance program, a drug injection site where nurses supervise as
heroin addicts shoot up, and a clinical trial testing whether chronic
opiate addicts can be helped with prescribed heroin.

Now, the city that has made a habit of being the first to try new
approaches to drug treatment, and that has tried just about
everything in the book, will broaden its battle against drug
addiction with a new program starting in the fall.

The Chronic Addiction Substitution Treatment program, announced in a
press conference by Mayor Sam Sullivan yesterday, will use legally
prescribed drugs, dispensed by local pharmacies, to try to help
people kick their addictions to cocaine, amphetamines and other stimulants.

CAST, said Mr. Sullivan, is a three-year research trial that will
target chronically addicted people in the Downtown Eastside, an
impoverished neighbourhood where the city's drug problem is most
heavily concentrated.

"I want to emphasize we will not accept the use of illegal drugs.
Only legally prescribeable, orally administered, pill medicines,"
said Mr. Sullivan, who earlier this year announced a plan to clean up
Vancouver's streets, called Project Civil City, that put an emphasis
on law enforcement.

He said the comprehensive nature of the CAST program, which will
include counselling and initiatives to end homelessness, makes it unique.

"The CAST project will take us down a road that is not completely
uncharted, but which has much territory to be explored. We might
possibly lead the world in more intelligent and compassionate options
in dealing with this problem," Mr. Sullivan said.

Funds for the project are not yet in place, but Mr. Sullivan said
$50,000 in seed money has been provided by Don Rix, chair of Metro
Laboratories, and he will approach the federal and provincial
governments for support.

CAST will work with addicts who volunteer for treatment after being
referred by health workers, police and social agencies in the
Downtown Eastside. Chronic offenders, defined as those arrested five
times or more in the past year, will get priority, along with prostitutes.

Mr. Sullivan said more people in the city take cocaine and
amphetamines than inject heroin, which suggests a stimulant
maintenance program could reach a larger number of drug users than
the heroin-treatment programs.

In 1989, Vancouver started the first needle exchange in Canada. In
1995, the B.C. Methadone program was offered under the management of
the College of Physicians and Surgeons of B.C. A supervised drug
injection site, the first in Canada, was started in 2004, and in
2005, Vancouver and Montreal became the first Canadian cities to
offer prescribed therapeutic heroin under the North American Opiate
Medication Initiative.

Dr. David Marsh, leader for addiction medicine, Vancouver Coastal
Health Authority, said the new CAST program will build on independent
studies from around the world.

"In terms of stimulant dependence, there are about half-a-dozen small
studies that have been done in the U.K., Australia and several in
Houston in the U.S. that have shown promising [results] . . . when
people who are dependent on methamphetamine or cocaine are given oral
doses of stimulants."

Dr. Marsh said the hope is that with a free, legal source of medicine
at their disposal, those addicted to stimulants might decrease their
use of illegal drugs and improve their social and physical health.

The project would be a clinical trial that would be monitored
throughout and it will need clinical trial approval from Health Canada.

He said oral opiates, like slow release morphine, will be among the
drugs used in the trial.

"Right now, if a physician wants to prescribe those medications,
either oral stimulants or slow release opiates, for treating
dependence in Canada, it's not really a legal thing that they can
do," Dr. Marsh said. "So in order to make that available as a
treatment option, it needs to be carefully evaluated in a way that's
ethically and scientifically and [from a] regulatory perspective, approved."