PROVIDING SAFE, DAILY DOSES HELPS ADDICTS, STUDY FINDS

VANCOUVER -- Most of the hardened heroin addicts who were given free,
daily doses of the illegal drug over a 12-month period underwent a
positive transformation, committing far fewer crimes while their
physical and mental health steadily improved, according to
researchers. Addicts also cut their illegal heroin use by 70 per cent,
on average, according to researchers from the North American Opiate
Medication Initiative.

The results of the trial, said Martin Schechter, the project's main
investigator, show that hard-core addicts - those with the dimmest
chances of recovery - can stabilize their lives when heroin is made
free and administered by teams of health-care professionals.

"Heroin-assisted therapy is a safe and effective treatment for people
with chronic heroin addiction who have not benefited from previous
treatment," Dr. Schechter told a news conference in Vancouver.

The federally funded clinical trial began three years ago with
researchers at Vancouver's University of British Columbia and the
University of Montreal scouring both cities for heroin addicts,
eventually finding 251 drug users who had previously tried - and
failed - to overcome their addictions.

Forty-five per cent of the participants received heroin, another 45
per cent received methadone and 10 per cent of the group received
hydromorphone, a prescription painkiller.

Those who received the hydromorphone - also known as Dilaudid - did
not know they were taking the prescription drug, nor did the
researchers who administered it.

As the program progressed, Dr. Schechter said all but one of the 25
hydromorphone users believed they were taking heroin.

The purpose of the hydromorphone study was to see how addicts
responded to it.

The results have implications for future treatment options, Dr.
Schechter said. The study showed that hydromorphone treatment can
stabilize heroin users just as well as real heroin.

He said jurisdictions that are leery of heroin-assisted drug programs
- - for political, legal or ethical reasons - may be more willing to try
hydromorphone instead.

Researchers have appealed to provincial governments to fund a resumed
operation for the clinics, and to immediately allow the use of
hydromorphone to treat addicts.

The aim of the heroin study was to determine whether a regular and
safe supply of heroin could stabilize the lives of addicts, perhaps
leaving them in better shape to seek help.

The NAOMI study was funded by an $8.1-million research grant from the
Canadian Institutes of Health Research.

The heroin and hydromorphone participants received three doses a day
from health-care professionals in downtown clinics. Most participants
- - 192 - were from Vancouver. Fifty-nine were from Montreal.

After one year, 90 per cent of the addicts being provided heroin were
still in the program and 54 per cent in the methadone program remained
- - much higher than the retention rates for conventional treatment, Dr.
Schechter said.

Researchers said they found a decrease in criminal activity and use of
street drugs, and an improvement in health among participants.

Participants must have been addicted to heroin for at least five years
and attempted treatment twice in the past.

"This is a group that society has written off as beyond hope," Dr.
Schechter said.

He said researchers tried to get participants into other conventional
therapies, such as methadone.

"Some people do go on to methadone but some do not, and the people who
do not relapsed very quickly to back where they were before the study
began."

Researchers continued to follow participants' progress after the
treatment ended, but many have already relapsed, he said.

Among the study's other findings: Illicit heroin use dropped 70 per
cent among all participants, and the percentage of those involved in
illegal activity fell to about 36 per cent from just over 70 per cent.

The money participants spent on illegal drugs dropped from an average
$1,500 a month to between $300 and $500.

The study ended in June, 2008.

Life facts of addiction

Demographic characteristics of participants in the Vancouver and
Montreal heroin study: (Figures given are percentages.)

Age: 39.7

Female: 38.6

First nation: 23.9

Current housing

Stable: 27.1

Precarious: 72.9

Generally unemployed in the past three years: 70.9

Received public assistance in the past 30 days: 76.1

Received money through illegal sources in past 30 days:
67.3

Involved in sex work: 17.5

Ever charged for crime: 94 per cent

Ever convicted: 81.7

Money spent on drugs in the previous month: $1,500

Days spent in illegal activity in previous month: 15

AVERAGE DRUG USE

Days of heroin use in previous 30 days: 26.5

Days of crack cocaine use in prior 30 days: 13.4

Days of speedball use in prior 30 days: 2.7

Number of times injecting drugs in a day: 4.8

Years injecting drugs: 16.5

HEALTH STATUS

(figures are percentages)

Hepatitis C positive: 62.9

HIV positive: 9.6

Ever attempted suicide: 31.3

Number of previous treatments: 7

Overdoses in life: 4.1

SOURCE: The North American Opiate Medication Initiative