FREE HEROIN TO HELP ADDICTS BAD IDEA

Safety, Ethical Issues At Stake

A controversial program to give free heroin to addicts in the
Vancouver area is under fire from addiction experts.

Under the trial programs, to be funded by the Canadian Institutes of
Health Research (CIHR) in Vancouver, Toronto and Montreal, 470 addicts
would be prescribed up to 1,000 milligrams of heroin and/or unlimited
methadone per day.

Two staff physicians at Toronto's Centre for Addiction and Mental
Health have written scathing critiques of The North American Opiate
Medication Initiative (NAOMI) to Diane Fafard, ethics policy advisor
for the CIHR in Ottawa.

"The NAOMI trial has serious design flaws and major safety and ethical
problems," wrote Drs. Meldon Kahan and Kay Shen in a letter dated Dec.
21, 2004. "If these are not solved, it will not only put research
subjects at risk. It will mislead researchers, clinicians and
policy-makers, and a unique opportunity to rigorously evaluate this
treatment will have been lost."

Heroin addicts who have failed methadone treatments will receive an
unrestricted amount of methadone, or methadone and heroin. The addicts
will inject heroin two to three times per day for one year, then they
will be tapered off the drug.

The trial, which has the blessing of the federal government, is the
first of its kind in North America. It was patterned after a similar
trial in Europe and will involve 158 local drug-users over 21 months.

The doctors have 20 years' experience in the field of addiction
research. They write in their letter that they are in favour of "harm
reduction" efforts, but say the trials are wrong-headed.

In Vancouver, addiction expert Dr. Stan deVlaming has written to
Providence Health Care vice-president Yvonne Lefebvre saying he "and
other addiction physicians here in Vancouver to share similar concerns."

Toronto doctors have a series of concerns, including: "strong
evidence" that the combination of large amounts of heroin and
methadone "put subjects at significant risk for acute and chronic
hypoxia." Hypoxia is a lack of oxygen in the blood and tissues of the
body. It can lead to death.

The doctors warned that some patients who are addicted to legal
heroin-like drugs could be put on the program and become addicted to
heroin.

The doctors wrote that the trial will set back heroin addiction
research for years to come.