HEROIN'S MEDICINAL USE ADVOCATED

Methadone Not Always Effective

The medical use of heroin is being advocated for a small number of
persistent drug users in Canada by the keynote speaker at a Calgary
conference Monday.

Ralf Jurgens, executive director of Canadian HIV-AIDS Legal Network, told a
conference on harm reduction in people at risk of AIDS and hepatitis, that
heroin and methadone substantially reduce crime and disease among injection
drug users.

Although methadone is the most effective treatment for heroin users, for a
small number of long-term addicts it doesn't work, Jurgens said in an
interview after his speech. For those people, medically prescribing heroin
enables them to go back to their jobs, improves their health and reduces
drug-related crime.

Studies in Switzerland show a 60-per-cent reduction in crime, a 50-per-cent
drop in unemployment and improved health for those receiving medically
prescribed heroin. There are also big savings in costs to society for
imprisonment and law enforcement.

Jurgens said the medical use of heroin should be scientifically studied in
Canada and compared with conventional treatment to measure benefits.

Staff Sgt. Paul Laventure, in charge of the Calgary Police Service drug
unit, said heroin is illegal and it would require a change in federal law
to make medicinal use for addicts possible.

If the law was changed, police would apply the law as they have done with
the medicinal use of marijuana.

Jurgens said it is hard to understand why Calgary and other parts of
Alberta do not have methadone treatment programs. The only Alberta program
is in Edmonton, and Calgary addicts who want to take part in the program
have to travel there.

Methadone, together with needle exchange programs, has been shown to be the
most effective treatment for opiate users.

It reduces crime and levels of hepatitis and AIDS among injection drug
uses, Jurgens said. One study showed methadone users are four times less
likely to contract HIV infection than people who are not.

"That is why it needs to be available broadly everywhere in the province,"
Jurgens said.

He disagreed with a common complaint that methadone programs draw drug
addicts to the city where it is offered, citing international evidence for
his view.

Calgary has a narrow window of opportunity to prevent a steep rise in the
number of injection drug users infected with HIV and hepatitis. At present,
Calgary's rate is low, at about two to three per cent. But in many other
Canadian centres it has risen to rates of more than 20 per cent, Jurgens said.

Diane Nielsen, public health nurse and co-ordinator of Safeworks, a
needle-exchange program run by Calgary Regional Health Authority, agreed
with the need for a methadone program in Calgary.

"Methadone gives injection drug users an opportunity to carry on with a
more stable lifestyle without the harm of HIV and hepatitis because they
aren't injecting," said Nielsen.

She said it is still a struggle to convince some sectors of society that
methadone is a good idea.

"It is controversial with some of the city police and Justice Department
representatives," she said. "but we are building their interest."

She also agrees with the limited medical use of heroin.

"But that is farther on the back burner for us than methadone, which is
already being used in Edmonton," she said.