LANDMARK HEROIN STUDY SET TO BEGIN IN VANCOUVER

Treatment Clinic, Part Of Salome Research, Will Examine Therapy For
Addicts Who Have Not Responded To Methadone

Just weeks before the spotlight hits Vancouver for the 2010 Winter
Olympic Games, a landmark medical study is set to begin, drawing
attention to the one class of Vancouverites that the city doesn't
want to showcase: Heroin addicts.

The four-year trial will provide 322 chronic addicts at a private
Vancouver clinic with heroin or a legal substitute opiate, Hydromorphone.

"This could revolutionize heroin treatment internationally," said
Trish Walsh, executive director of the InnerChange Foundation. "It's
exciting to start this before the Olympics, we think it's a great
opportunity treat the root cause of homelessness in the Downtown Eastside."

It took more than a year for study organizers to get regulatory
approvals to import heroin and to gather the finances, which are
coming in part from the private sector. A second clinic was planned
for Montreal but without the authorization, the researchers decided
to proceed with just one.

The research arm of Health Canada has approved the Study to Assess
Longer-term Opioid Medication Effectiveness (SALOME) as a way to
examine alternate therapies for addicts who have not responded to
conventional methadone treatment.

The researchers will attempt to determine if heroin addicts will
accept an alternate narcotic that is legally available in Canada, and
will examine if providing those drugs in a pill form, rather than by
injection, is effective. If successful, Ms. Walsh said, it would be a
groundbreaking new treatment in a field where few options are
available, especially in Canada.

While the long-term goal is to help the addicts get off hard drugs,
in the short term, the plan is to get them away from the more
dangerous and troubling aspects of heroin addiction, such as
committing crimes, sharing needles and shooting up in back alleys.

The clinical trial builds on an earlier Canadian heroin trial, the
North American Opiate Medication Initiative (NAOMI). The researchers
found that participants who were given heroin in a clinic were
healthier and committed fewer crimes to pay for their habits.

The results of NAOMI were published in the New England Journal of
Medicine last August and garnered international media attention. A
small portion of the participants in that study were given
Hydromorphone to serve as a control group, and researchers were
surprised to discover how effective it seemed to be. This study will
test the drug more broadly to see if it can be proven to work as a substitute.

Ms. Walsh said the success of the NAOMI study will ensure this trial
will be followed closely. "NAOMI showed there are solutions to
helping to end the crisis in the Downtown Eastside," she said.

But for a wider audience, there is considerable interest in a
treatment that does not involve injection drugs. Being able to take a
narcotic in pill form reduces the need for medical staff at the
clinic, and also reduces the stigma when persuading policy makers to
approve treatment funding. Although there has been little
encouragement from the federal government for Insite, Vancouver's
safe injection site, Ms. Walsh said the goal is to have heroin or
Hydromorphone available as a treatment option.

"There are approximately 5,000 chronic addicts in the Downtown
Eastside," she noted. "So there is so much more we have to do. This
is a very exciting trial, but the goal is to have this as a model for
treatment in Vancouver and across Canada."

In January, the research team will finalize the location of the
Vancouver clinic and will begin consultations with stakeholders in
the Downtown Eastside. They'll begin taking applications for clients
in February.

Participants must be adults and, as in the NAOMI trial, must be able
to demonstrate that methadone treatment has failed them.