WE'VE GOT TO CHANGE ATTITUDES ABOUT ADDICTS

Giving Heroin to Junkies Could Turn Around Many Wasted Lives

A fitting reward for the well-heeled landowners whose decaying
Downtown Eastside hotels aren't even fit for the area's scavengers
and addicts would be a lengthy stint in one of the foul, filthy rooms
they let for top dollar.

But recent reports of the disgustingly dirty, dangerous interiors of
Vancouver's seediest flophouses not only help expose the callousness
of some megamillionaire businessmen -- they also punctuate the
absence of options for the most wretched.

There was a time when I comfortably turned a blind eye to the
infestation of junkies and parasites who collect at the grey-grim
corner of Main and Hastings. After all, much of it was, and still is,
their own doing.

But the price tag for maintaining them in their sordid surroundings
made me come to my senses.

The social-cost casualty of substance use in Canada: more than $8
billion, according to a report by the city's drug-policy chief, Don
MacPherson, and staff.

At least a billion of it is invested here in our own back yard every
year, with no significant improvement to their setting, their
lifestyles or the safety of our communities. There's got to be a more
humane way for these outcasts to survive -- and it's up to us to find
it, whether we want the job or not.

That's where the substitution treatment initiatives of other
countries cited in the study come in handy. Albeit politically
controversial, they are the templates for five clinical research
trials being organized by a local charity that has the toughest,
hardened users in its sights.

The only available replacement treatment for heroin addicts in
Vancouver at the moment is the methadone prescription, written up for
about 2,729 addicts by 76 licensed pharmacists.

But it's just the tip of the syringe needle, sort of speak. Partly
because methadone doesn't cut it for treatment-resistant heroin
addicts and partly because it doesn't address the increase in
stimulant dependency, such as cocaine, crack, meth and other amphetamines.

Dishing out free heroin to habitual users is unpalatable to many
Canadians, but we shouldn't let our preconceived ideas obscure the
gains other jurisdictions have made in battling crime, reducing
homelessness and increasing employment among junkies.

Although heroin-assisted treatment reached only a relatively small
group of addicts in Switzerland, the results, according to police
records and individual testimony, are significant: Income from
illegal activity fell to 10 per cent from 70 per cent; offences
decreased by 60 per cent; homelessness fell to one per cent from 12
per cent while employment doubled to 32 per cent.

HAT clinical trials in the Netherlands and Germany boasted similar
results: "Higher retention rates, improvement in physical and mental
health, decline in street-heroin and cocaine use, as well as in
high-risk behaviour [such as needle sharing]," the study reported.

The North American Opiate Medication Initiative is the only parallel
program here.

NAOMI began administering medically prescribed heroin to Vancouver
and Montreal-based treatment-hostile addicts two years ago. Findings
are expected late next year.

Like-minded programs for stimulant-addicted users are tougher to come
by, due to a shortage of appropriate substitute medicines.

But local groups such as the Inner Change Society are seeking funding
for the clinical trials they hope to run for crackheads and other
habitual adrenalin rushers.

The city's MacPherson and co-author Zarina Mulla support efforts to
expand the options but say it's just part of the picture: "Treatment
programs are most effective when they're part of a comprehensive
approach to the city's drug problems," the report concludes, noting
that supported housing and programs to reintegrate individuals into
the community are also a must.

We've got little to lose.