HEROIN ON THE MENU AS SALOME STUDY FLIES UNDER RADAR

Hundreds of Addicts Will Receive High-Grade Government Heroin or Dilaudid

Heroin treatment in Vancouver is a joke. The majority of addicts
participate, to varying degrees, in the so-called methadone
maintenance program, which received unwanted media attention in 2008
due to alleged corruption and kickback schemes involving methadone
pharmacies in the Downtown Eastside. The program includes no
mandatory counselling or supplementary drug treatment and many
addicts remain on methadone for decades. Living addicted lives.
Robbed of their destiny.

From this destitute population, organizers of SALOME (also known as
the Study to Assess Longer-term Opioid Medication Effectiveness) plan
to enlist 322 participants for an unprecedented Canadian experiment.

The plan goes like this: participating addicts will receive up to
three daily injected doses of government heroin or Dilaudid, a
powerful opioid derived from morphine. After six months, the addict
will either continue injecting or switch to the same drug in oral
form (pills or liquid) for another seven months before exiting the
study. In theory, by monitoring addicts, researchers will gauge the
effectiveness of oral treatment. A "stabilized" addict, they say, is
more susceptible to recovery and less inclined to crime and disease.
Like the methadone program, SALOME does not include mandatory
counselling or supplementary drug treatment.

It will all happen at 84 West Hastings, under the watchful eye of
nurses from Providence Health Care. According to regulations, nurses
may help addicts "tie off" but can't physically wield the needle or
push the plunger. Taxpayers and private donors will split evenly the
heretofore unknown costs of SALOME's four-year study.

Sounds simple enough, if not somewhat surreal. But things have bogged down.

Trish Walsh, director of the InnerChange Foundation, SALOME's
fundraising wing, announced last year that the study would begin
before the Olympics. Yet here we are in August and SALOME remains
stuck in the blueprint stage. In Canada, it's illegal to manufacture
heroin (technically known as diacetylmorphine). Thanks to a federal
exemption, an unnamed pharmaceutical company will import the narcotic
from the United Kingdom. Walsh refused to be interviewed for this
story but Justin Karasick, a spokesperson for Providence Health Care,
blamed the delay on "typical issues" associated with shipping the
heroin across the pond.

Nevertheless, during a phone interview last Friday, Eugenia
Oviedo-Joekes, a research scientist at UBC and one of the main brains
behind the study, dismissed any notion of a SALOME stutter-step.

"Delay? Every clinical trial takes time to develop," said
Oviedo-Joekes, a gregarious woman with a distinct Spanish accent.
"The fact that you have to import the medication adds a bit of time
to the normal process that any other clinical trial will have."

Oviedo-Joekes has been around. She presided over the similar NAOMI
heroin study conducted earlier this decade at the same location on
West Hastings. Before that, she helped orchestrate a heroin trial in
Granada, Spain where she says addicts continue to receive heroin as a
form of drug treatment.

Here in Canada, there is virtually no public opposition to SALOME
mainly due to media disinterest. The Harper government famously
opposes Insite, the supervised injection site at 139 East Hastings
St., yet remains mum on SALOME. Which is curious, because SALOME
(where heroin is purchased and prepared for users) makes Insite
(where addicts must find and buy their own heroin) look like a candy
store by comparison.

Despite the difference in public profile, SALOME and Insite bare
similar traits.

In an apparent conflict of interest, beginning in 2003 Insite
researchers were charged with justifying Insite's existence, and as a
result, produced dozens of studies championing Insite's benefit to
drug addicts.

Similarly, the SALOME study is not--as advertised--designed to
discover the benefits of narcotic-assisted treatment. Rather it will
administer treatment SALOME architects such as Oviedo-Joekes and the
elusive Dr. Michael Krausz already believe in. Oviedo-Joekes
practically admits as much, proudly pointing to her Spanish
experience and lauding the "success" of the NAOMI heroin trials.

Oviedo-Joekes refused to speculate on a start date, citing the
"stress and anxiety" potential SALOME participants would experience
while waiting for the study to be begin. Nevertheless, once the
heroin arrives, SALOME will happen. And up to 322 addicts will add
government dope to their daily fix. Whatever your feeling or
perspective about drug treatment in the Downtown Eastside, that's a
reality worth pondering.