HEROIN STUDY VIOLATES ETHICS, ACADEMIC SAYS

VANCOUVER -- A controversial proposal to offer free heroin to addicts in
Montreal, Toronto and Vancouver for research purposes violates ethical
norms, Canadian bioethicist Louis Charland says.

"How can an individual who is addicted to heroin voluntarily consent to
participate in research where their drug of choice is offered free of
charge?" Prof. Charland stated in a recently published article in the
American Journal of Bioethics.

"When I put these questions to Cynthia, a recovering heroin addict at a
local clinic, her reaction was disbelief and amazement. 'That's crazy,' she
said. 'If you're addicted to heroin, then . . . you can't say no to the
stuff.' "

Prof. Charland, who teaches in philosophy and health-science departments at
the University of Western Ontario, said heroin addicts with a compulsive
need to use the drug cannot satisfy a research standard of competent and
informed voluntary consent.

"Ethical and clinical discussions of heroin prescription seem to have
missed this point entirely," he said in the journal, based at the
University of Pennsylvania Center of Bioethics.

A group of Canadian researchers are currently putting together a proposal
for a national project to evaluate whether free heroin for addicts will cut
crime, control health costs and help the drug users deal with their addiction.

The first meeting of an advisory group for the research project is to be
held next month. A formal application for federal funding will likely be
considered this winter. The proposal also requires the approval of an
ethical review committee.

The proposal is that addicts in the study receive heroin under medical
supervision for a year. A control group would be offered methadone, a drug
that eliminates an addict's desire for heroin without providing the high.

A similar research project in Switzerland in the 1990s found that
prescription heroin led to a decrease in the use of all types of illicit
drugs, reduced criminal behaviour and improved health. Swiss researchers
concluded that heroin prescription was both feasible and clinically effective.

However, the Swiss research "would appear to violate existing North
American ethical standards for clinical research," Prof. Charland stated.

In an interview, Prof. Charland said he was undecided about whether
research on heroin prescriptions should go ahead.