SMOKING HEROIN DANGEROUS

The city's chief medical health officer is investigating why three Vancouver
residents have died since last fall and seven others suffered varying
degrees of brain damage from smoking heroin.

Dr. John Blatherwick said the 10 cases comprise the largest group of toxic
heroin reactions in such a short time period ever in North America, and he's
worried more people could die or fall ill before the cause is determined.

His investigation, however, is hampered by the difficulty of getting solid
information from the living victims, who either can't speak or have
irreversible brain damage. The victims are all adults, seven of whom live
outside the Downtown Eastside.

"This is just not a Downtown Eastside story," Blatherwick said. "This is
nice upper middle class people having drugs brought to their house, and this
is destroying their brains for the rest of their lives."

Called "heroin-induced toxic leukoencephalopathy," the condition involves
alteration of the white matter of the brain through exposure to a toxin or
poison. Blatherwick believes the heroin, its cutting agent or possibly the
aluminum foil used in smoking the drug is responsible for the damage.

Heroin is smoked by heating the powder on a piece of tin or aluminum foil
over a flame. The resulting white smoke is inhaled, sometimes using a tube
or rolled foil cylinder. The practice is often called "chasing the dragon."

Since brain damage is usually permanent, early detection of the condition
and immediately eliminating exposure to heroin smoke is essential, said
Blatherwick, noting the 10 cases were reported at Vancouver General Hospital
and St. Paul's Hospital.

The condition was first reported in Amsterdam in 1982. In the past 20 years,
sporadic cases have appeared in Europe, the United States, Canada, Taiwan,
China and Lebanon.

Det. Robb McLaren is investigating the cases on behalf of the Vancouver
police drug unit, which recently conducted a covert "dial-a-dope"
investigation to catch dealers delivering drugs to peoples' homes.

Buys were made across the city, resulting in the arrest of 34 suspected
dealers. McLaren said many customers outside the Downtown Eastside prefer
smoking instead of injecting heroin to conceal the fact they are addicts.

"You don't have to worry about cooking it, sticking it in a needle, stick it
in your arm, find a vein-all that ugly stuff," said McLaren, noting,
however, that both methods of abusing the drug are equally addictive.

Traditionally, heroin is cut with glucose-which is harmless and often used
for children who are lactose intolerant-to decrease the purity and spread
out a dealer's drug supply. But McLaren has also heard of cases where heroin
was cut with caffeine and even strychnine.

Dean Wilson, president of the Vancouver Area Network of Drug Users, suspects
the victims may not have been smoking heroin at all. He believes it could be
fentanyl, a synthetic narcotic whose biological effect is indistinguishable
from that of heroin, except that fentanyl may be hundreds of times more
potent.

Fentanyl is most commonly used intravenously, but like heroin, may be smoked
or snorted.

Smoking heroin is not a new phenomenon, McLaren said, pointing to the Opium
Wars in the early 1800s, when the English shipped tons of opium-from which
heroin is derived-from India into China in exchange for manufactured goods
and tea.

This trade produced a country filled with drug addicts, as parlours for
smoking opium proliferated throughout China in the early part of the 19th
century.