OVERDOSE DEATH TOLL SPURS CANADA TO CONSIDER PRESCRIBING HEROIN

U.S. Unlikely To Try Similar Program

VANCOUVER, British Columbia (AP) -- Dismayed by a horrific death toll from
drug overdoses, Vancouver authorities are nudging Canada steadily closer to
breaking a North American taboo by supplying heroin to addicts.

So far this year, 224 people in British Columbia -- mostly from Vancouver's
skid-row areas -- have died of overdoses, up 40 percent from last year.

The deaths, blamed on an influx of cheaper and more potent heroin, prompted
the provincial health officer, Dr. John Millar, to recommend last month
that health workers provide heroin to certain addicts on a trial basis.

The aim would be to reduce the risk of overdose and restore some stability
to the addicts' lives by freeing them from the daily scavenging for money
to buy their next fix.

Such programs have been tried on a limited basis in Western Europe, but
never in North America. Many experts believe heroin trials are unlikely to
take place in the United States anytime soon because of firm opposition
among many lawmakers, while Canadian officials and politicians are
considered more receptive.

Vancouver's chief coroner has endorsed the plan. Even the city police chief
has expressed cautious interest because of the prospects of reducing
addiction-related crime.

The federal health agency, Health Canada, says it would be willing to
authorize clinical trials in which doctors could prescribe heroin to addicts.

Swiss experiment got mixed reviews

On Tuesday, the lawmaker who represents Vancouver's worst skid-row
neighborhood in Parliament introduced a motion urging the federal
government to launch such trials immediately.

"People are dying in the streets because we have failed to act," said Libby
Davies.

Her district includes the Downtown Eastside, a pocket of rundown rooming
houses, pawn shops and bars a few blocks from Vancouver's posh cruise-ship
pier. Rampant intravenous drug use has saddled the neighborhood with one of
the highest rates of HIV infection in the developed world.

The most ambitious experiment with prescribed heroin has been in
Switzerland, where 1,146 addicts received thrice-daily injections in
1994-1996. The program's researchers said crimes committed by those addicts
dropped sharply and many were able to find jobs and decent housing.

But critics questioned the accuracy of the findings, while others say any
plan condoning drug use sends a bad message to young people.

In the United States, the Swiss program has received little serious
consideration, according to Ethan Nadelmann, director of a New York-based
drug policy think tank, the Lindesmith Institute.

"There's been a de facto self-censoring of any discussion of this," he
said. "There's a reluctance to keep people on drugs they might like."

One of the few U.S. jurisdictions to openly contemplate Swiss-style heroin
maintenance is Baltimore, but officials there say it could be two years
before anything is in place even if federal approval is granted. Davies
hopes Canada can act more swiftly and perhaps provide ammunition for
Americans seeking to modify U.S. policy.

Canada a better bet than U.S. for pilot program

Dr. David Lewis, director of the Center for Alcohol and Addiction Studies
at Brown University, is one of the leading American experts in the field.
He believes heroin prescription tests have a better chance of getting
launched in Canada.

"The ideological barriers to doing a pilot program are less in Canada ...
it's a little less edgy in terms of the moral crusade aspect," he said.

Among law enforcement officials, there are sharp divisions over heroin
prescription programs.

"It sends us down a path," said Inspector Richard Barszczewski, a drug
specialist with the Royal Canadian Mounted Police. "Would we then be
suggesting for the cocaine addicts we should give them cocaine? For
alcoholics, should we give them alcohol?"

But for Vancouver policeman Gil Pudar, heroin prescription makes sense in
terms of crime-fighting and economics. He says 90 percent of property crime
in his district is committed to support addictions.

"The criminal justice system is the most expensive method of intervention,"
he said. "Why are we spending millions of dollars chasing our tail when all
we're doing is making the problem worse?"

Copyright 1998 The Associated Press.

Checked-by: Richard Lake