FREE HEROIN FOR ADDICTS? THE IDEA MAY NOT BE AS MAD AS IT SOUNDS

It's crazy to give free heroin to addicts, isn't it? Many people
respond initially with a resounding yes. But the idea may not be as
mad as it first sounds.

Heroin addiction is a major health problem affecting 60,000 to 90,000
Canadians. The risks include deadly overdoses, lethal infections such
as AIDS and hepatitis C, social disintegration, violence and crime.
The enormous burdens on communities include medical care, public
health, policing, criminal justice and jail expenses as well as
public disorder and crimes against people and property.

Methadone, the "gold standard" treatment, is effective for many
people. But there are also many who have not benefited from this
treatment and who remain outside of the health system. They are
injecting in alleys and flophouses right now, using contaminated
heroin with dirty needles then selling their bodies and committing
crimes for their next fix. Does anyone think this will make them
better? What if we could get them in off the alleys and out of the
black market? What if we could replace the cycle of crime with a
cycle of daily contact with doctors, nurses and counselors?

That is why, in Vancouver and Montreal, our team conducted the North
American Opiate Medication Initiative, a clinical trial that
investigated the potential benefits of prescribed heroin administered
under tightly controlled medical supervision. It is an idea that has
proven successful in Switzerland, Holland and Germany where it is now
part of the health system. In fact, in a referendum just last week,
an overwhelming majority of Swiss citizens - 68 per cent - voted to
continue the program that treats 1,300 people there.

This treatment is not for everyone. In NAOMI, we took only the
hardest core addicts - who had been addicted an average of 16 years,
who had tried methadone an average of three times in the past without
success, who were not in any treatment and injecting street heroin
every day. And guess what happened? After 12 months, almost 90 per
cent had stuck with the program, use of street drugs declined
dramatically, psychological and medical health improved, criminal
activity dropped in half, and the monthly amount spent buying black
market drugs fell from $1,500 to $300.

No question that the blood of some readers is beginning to boil.
After all, isn't this just another bleeding heart proposal that will
encourage drug use and coddle addicts? Shouldn't we be cracking down
even harder instead and throwing these people into prisons where they
belong? And isn't this just another lame-brained waste of taxpayer
dollars? Well, let's take a look at the facts.

As things stand, we are already spending a fortune in tax dollars -
the only difference is that it goes to prisons, hospitals, courts and
lawyers. Every untreated heroin addict costs taxpayers at least
$50,000 per year, while the NAOMI treatment costs about $8,000. This
savings should please the most hard-hearted of fiscal conservatives.
And the crackdown and incarceration approach, as appealing as it is
to some, just plain doesn't work. Consider the U.S. experiment -
where they incarcerate more people per capita than any other country
on Earth. Home to five per cent of the world's people but 25 per cent
of its inmates, the U.S. can't build prisons fast enough - driven in
large part by drug-related crimes. Like it or not, we simply can't
incarcerate our way out of the addiction problem.

Someone who had been a NAOMI participant recently wrote us from a
treatment facility outside Vancouver:

"I want to tell you what being a participant in this study did for
me. Initially it meant "free heroin". But over time it became more,
much more. NAOMI took much of the stress out of my life and allowed
me to think more clearly about my life and future. It exposed me to
new ideas, people (staff and clients) that in my street life (read:
stressful existence) there was no time for.... I am definitely not
"out of the woods" yet, but I feel I am on the right path. And this
path started for me at the corner of Abbott and Hastings in Vancouver.

Is it crazy to give free heroin to addicts? Maybe so, but perhaps
there is method in this madness.