HEROIN EXPERIMENT 'BENEFITS' EVERYONE

The clinical trial aims to keep drug users off the streets

Dr. Martin Schechter believes an experiment giving a number of Vancouver
drug users heroin is a necessary one that will benefit the community along
with users.

"These 160 or so people, they will not have to engage in criminal activity
because they will know that their allotment of heroin is going to be
provided by a doctor," said Schechter, a University of B.C. researcher who
is the principal investigator for the Vancouver portion of the Canada-wide
experiment.

It involves giving a select group of heroin users their drug to see if it
helps stabilize them and improve their health.

"The whole idea of the study is that if they don't have to go stand on the
street and sell sex or break into cars or burglarize your house, there may
be a window of opportunity where you could actually get them to break that
cycle and get them out of that spiral," Schechter said.

The clinical trial hit the headlines last week when a letter went out to
residents near the 600-block East Hastings advising them a development
permit had been requested for a site on that block in order to run a
two-year experiment in prescribing heroin.

The North American Opiate Injection Trial, or NAOMI, as it is known, is
supposed to begin in March, along with similar trials in Toronto and
Montreal.

While there was little opposition from local groups to the idea of the
trial, many said they didn't like the location -- a block from a school, a
half block from a day care, and next to a new housing complex built by the
Union Gospel Mission specifically for people who want to live in a drug- and
alcohol-free environment.

Schechter admitted that the original experiment, which first started being
discussed in 1997, was supposed to include American test sites as well,
which is why it was called the North American trial.

"But obviously, the environment in the United States is not particularly
amenable to this kind of study," said Schechter, speaking from New York. "I
think there was hope among our American colleagues that some cities would be
able to participate. But as time went on, it became more and more clear that
they wouldn't be able to."

The experiment, which will involve 470 people in the three Canadian cities,
will see about half of the users getting the heroin substitute, methadone,
which is already commonly used for people trying to quit, and the other half
getting prescription heroin. In Vancouver, 88 people will get heroin and 70
will get methadone.

Those chosen will have to be long-term residents of the Downtown Eastside
who have been addicted for a number of years and have tried methadone
programs more than once and failed at them. Those who stay with the trial
will receive about $100 over the course of the 15 months they are in the
program to pay them for filling out lengthy evaluations at certain points in
the trial.

Both groups will get extensive counselling and support in trying to quit
altogether.

The experiment is modelled after studies in Europe, which showed that users
given heroin had a better success rate of stabilizing their lives, improving
their health, staying housed, and keeping out of jail than those who were
using methadone or trying to quit altogether.

Schechter said he finds it hard to understand the concern people have about
children or others having to walk past the building.

"The children who walk to those schools pass injection drug users every
day."

He said that, at least with an experiment like this, there will be 160 fewer
people on the streets injecting.

"The people who are going to be in this study are there right now. They are
chronic heroin addicts and they are in the Downtown Eastside injecting as we
speak, injecting dirty heroin with unsafe needles and they do it in the
alleys and the hotel rooms and apartments and the cars in this
neighbourhood. And we are going to 160 of those folks and bring them into
treatment with the best available therapies."

Schechter said the trial has already received approvals from ethics review
boards at the three participating universities, along with the body that
regulates the prescription of medications in experiments.

The trial is now waiting for approval, just as Vancouver's
supervised-injection site had to, from Health Canada, which needs to grant
it an exemption from the Narcotics Act.

He said everyone has been reluctant to talk publicly about the trial until
now because people thought it was inappropriate to talk about a trial that
hadn't been approved yet.

The trial has been granted $8.1 million from the Canadian Institutes of
Health Research, although that is a little short of the amount needed.

Schechter said the price of the heroin will be higher than originally
budgeted because the researchers were originally going to obtain a
particular formulation of the laboratory-produced drug and discovered they
couldn't do that, so they had to go to a different formulation and
manufacturer, which was more expensive.