TRIAL WOULD GIVE USERS LEGAL SUBSTITUTE DRUGS

Research Team's $3-Million Proposal Targets Cocaine and Crystal-Meth
Addicts

Vancouver is taking another step toward becoming the leading North
American laboratory for pioneer experiments in dealing with
illegal-drug addiction.

A Vancouver research team will put in a request this week to run
Canada's first trial in giving legal substitute drugs to cocaine and
crystal-meth users, says Richard Mulcaster, the director of a
non-profit organization formed to promote giving legal drug
substitutes to addicts.

The proposal, from a team that includes a leading European addictions
researcher now based at Vancouver's St. Paul's Hospital, will provide
four different kinds of substitutes in the 400-person trial.

About half of the trial participants would get substitutes; the other
half would get placebos. They would all get psycho-social counselling
and half of them would also get work-rehabilitation counselling, so
researchers can look at what combination helps users most in
establishing healthier lives.

Mulcaster said the trial, budgeted to cost about $3 million, should be
ready to start in the fall of 2008 if everything goes according to
plan.

The trial, along with four others in the works, and the non-profit
Chronic Addiction Substitution Treatment (CAST) group that Mulcaster
works for, all got their start 18 months ago. At that time, Vancouver
Mayor Sam Sullivan, then newly elected, said one of his main
initiatives would be to find ways to provide drugs to users so they
wouldn't have to commit crimes to get them.

He hoped originally that thousands of addicts could be provided with
drugs, which he believed would clean up most, if not all, of the
problems of the troubled Downtown Eastside. He also started raising
money to be used to put into those ideas.

Those dreams have now morphed into the separate non-profit group and
five possible trials involving Dr. Michael Krausz, an addictions
researcher from Hamburg who was involved in Germany's trials in giving
heroin to addicts. Krausz moved to Vancouver earlier this year, after
being chosen as the Leading Edge Endowment Fund (LEEF) chair in
addictions research at the University of B.C. He also works at St.
Paul's.

There won't be thousands of people getting substitute drugs, as
Sullivan envisioned.

About 1,000 people altogether would participate in four of the
clinical trials, with about half of them getting real drugs or drug
substitutes and the other half getting placebos.

A fifth program, which is the least developed of the initiatives and
won't be a formal research trial, envisions having an additional 1,000
crack and cocaine users get substitute drugs in a treatment plan that
would reward them for good behaviour.

But Sullivan said he's pleased with the progress made so
far.

"I realize you have to walk before you run. You need to do things
right."

He said that even if only a few people with serious crime habits end
up in one of the trials, that could have a significant impact, since
some addicts commit crimes five to 15 times a day to support their
habits.

Sullivan also said these trials will make Vancouver a world leader in
addictions research.

But the proposed trials still have several hoops to go through.
Besides the proposal going to the federal government this week, the
St. Paul's team has also submitted one letter of intent for a trial
similar to the North America Opiate Medication Initiative (NAOMI)
trial that has been going on in Vancouver for the past two years, in
which 192 people have been given either heroin or a substitute daily.

One of the proposed programs would continue on from the NAOMI trial,
which operates out of a building in the Downtown Eastside. In another
researchers will give substitute drugs for cocaine and crystal-meth
users.

Before any trials start, the federal government has to approve the
letters of intent, then approve a formal proposal, and then provide
research funding. As well, the team would need to find additional
money for the treatment portion of the trial, which is separate from
the research end.

Mulcaster said that's where CAST will come in, by pulling together
money from the provincial government, local agencies and private donors.