HEROIN ADDICTS TO GET DRUG FOR FREE

Study To Examine Health And Crime

Methadone to be offered after year

A small group of heroin addicts in Toronto will be given the drug for free
for a year as part of a controversial study -- the first of its kind in
North America -- set to begin next year.

Addicts will be able to get the drug and inject it three times a day at an
office of the Centre for Addiction and Mental Health, near Spadina Ave. and
College St., as part of an $8 million federally funded trial to see whether
it improves their health and cuts crime.

As part of the trial, they will receive counselling from doctors, nurses
and social workers. At the end of the first year, they will be weaned off
the drugs and offered methadone or withdrawal counselling for another year.

The study, which will also take place in Vancouver and Montreal, has not
yet received final approval from Health Canada because the City of
Vancouver must first approve a storefront clinic in the drug-infested
downtown eastside to dispense the drugs.

The Toronto study group plans to give out the drugs, which must be injected
on site, at the centre's main building on Russell St. but has not yet
received final approval, said Dr. David Marsh, the centre's clinical
director for addiction medicine.

It already runs many outpatient programs for addicts at the site.

The program has not been formally announced, but word leaked out because
Vancouver residents had to be told about the rezoning application for the
storefront clinic.

While many support the clinic, they are opposed to its location across the
street from a day-care centre and down the street from an elementary school.

Under the study, 210 addicts in the three cities -- a third of them in
Toronto -- would be given heroin seven days a week. Another 210 would be
given methadone and 50 would get hydromorphone, or Dilaudid, a drug
normally used to treat pain that has an effect similar to heroin.

The addicts must have twice failed to kick the habit in methadone treatment
programs.

The trial program has been under discussion and subject to rigorous ethical
study for the past five years, said Dr. Martin Schechter of the University
of British Columbia, the study's principal investigator.

"It's a very, very complex endeavour," he said. "There were a number of
approvals we had to obtain and are still in the process of obtaining," he
said. But it's important to realize the drug is going only to people
already addicted to heroin, he added.

"These are people buying the drug on the black market, sharing dirty
needles and spending most of their time in criminal activity like robbery
and prostitution in order to pay for their habit," Schechter said.

"If we can break this cycle of criminal activity, hopefully we can
stabilize their lives and get them the counselling they desperately need."

Similar studies in Switzerland and the Netherlands found that addicts made
improvements in their quality of life and employment, engaged in less
criminal activity and improved their over-all health, he said.

Methadone dependency is the only known effective treatment for heroin
addicts, but about half of them don't respond to it.

Peter Vamos, a psychologist and executive director of the Portage
Organization, a network of drug treatment centres in Canada, said the
problem with such experimental programs is they fail to deliver the
counselling addicts need.

"They're less likely to overdose and they have clean needles, but as far as
getting them any real help, they don't really seem to have that," he said.

When an uproar broke out in the Ontario Legislature a few years ago over
sending addicts to the United States for treatment, the government vowed to
stop the practice and set up treatment programs at home, Vamos said.

"They haven't invested in treatment and they're not sending them out of the
province either," he said. "Over the last several years, treatment has not
been a high priority."

But Richard Garlick, director of communications for the Canadian Centre on
Substance Abuse, said the study is "a very solid, well-thought out project.
This is just another step in what is becoming a wide variety of approaches
to addiction.

"It used to be one size fits all, but now we're realizing some people
respond to one kind of treatment and others don't," he said. "These are
people who have failed to respond to the only other major approach
methadone dependence. This is a sincere attempt to help those people."