ALTERNATIVE TREATMENTS GIVE ADDICTS A CHANCE

Maintenance Programs For Cocaine And Heroin Users Isn't So Different
Than Giving Meth To Hyper-Active Children

Vancouver Mayor Sam Sullivan's plan to set up an alternative
drug-treatment plan for 700 cocaine and crystal methamphetamine
addicts might never come to fruition, but it's something that should
be seriously considered.

The plan might not see the light of day because the federal
government has made it clear that it opposes any treatment or harm
reduction programs that involve providing addicts with drugs. Last
year, for example, the Conservatives refused to extend the life of
the supervised injection site for another 31/2 years, despite the
recommendations of scientists and Health Canada bureaucrats.

The science therefore might not sway the government to accede to
Sullivan's request that the program be exempt from Canada's drug
laws, but it should. Although the science is limited -- and that is
another reason to conduct a large-scale trial in Vancouver -- the
evidence we do have suggests that stimulant maintenance can have a
positive effect on the lives of at least some addicts.

Trials have already been conducted in a number of jurisdictions,
including Great Britain, which has been providing stimulants to
addicts since 1988, Australia, South America, and surprisingly, the
United States, and even more surprisingly, Texas. This means that,
unlike the supervised injection facility, a maintenance program in
Vancouver would not be the first of its kind in North America.

In fact, University of Texas psychiatry professor John Grabowski, who
has conducted maintenance trials involving the provision of
methamphetamine and dextroamphetamine, has said that interest in such
programs has been growing across the United States on the strength of
the results he has seen.

Grabowski has found that heavy stimulant users reduce their
consumption while on maintenance, and also report fewer signs of
depression and behavioural disturbances. This improved biological and
behavioural stability has allowed addicts to get on with their lives
and focus on such things as behaviour-control counselling: A 2001
trial in Sydney, Australia, found that dextroamphetamine therapy
increased the likelihood of addicts remaining in counselling.

Further, since many stimulant addicts currently inject their drugs --
and do so many times a day, unlike heroin users who inject once or
twice daily -- they are at greatly heightened risk of contracting
blood-borne diseases such as HIV and hepatitis C, and of suffering
from skin problems.

But as Simon Fraser University's Bruce Alexander and Jonathan Tsou
noted in a 2001 paper in Addiction Research and Theory, maintenance
programs could help addicts replace injections with oral medication
and avoid all the risks associated with injection drug use.

Stimulant maintenance, therefore, shows considerable promise and it's
worth conducting a trial in Vancouver to see if the results from
other studies are replicated.

The one thing standing in the way, it seems, is an ideology that says
we must never provide drugs like heroin or methamphetamines to
people. Yet we're already providing heroin to heroin addicts through
the North American Opiate Medication Initiative, and preliminary
results from those trials appear positive. We've also provided, for
many years, methamphetamines to children with attention deficit
hyperactivity disorder.

We ought, then, to have no ideological objection to providing
methamphetamines or similar drugs to cocaine and meth addicts. With
these ideological concerns swept aside, we should welcome a stimulant
maintenance trial in Vancouver to see if it can improve the quality
of life for users, and by extension, for us all.