British Columbia

Success of medical-grade heroin in Europe prompts calls for treatment in Vancouver

An international panel of researchers convened in downtown Vancouver to discuss latest research regarding the use of medical-grade heroin for treating addiction.

International panel of researchers gather in Vancouver

Russell Cooper questions why prescription heroin isn't implemented across Canada to help people battle heroin addiction. (Jon Hernandez/CBC)

Three years ago, Russell Cooper was living in a homeless shelter, addicted to heroin he would buy in Vancouver's Downtown Eastside. Now, he lives in his own one-bedroom apartment, and values the control he has over his life.

The Vancouver resident hasn't kicked his addiction, but he's mitigated the damage after becoming a patient at Vancouver's Crosstown Clinic, the only medical centre in Canada that prescribes medical-grade heroin.

"I'm at Crosstown Clinic twice a day, and its great," said Russell, who's one of the clinic's 95 patients — 23 of which receive hydromorphone, a legal, licensed opioid analgesic. "Life is good to me."

There are 600 people on a waitlist to get into Crosstown Clinic, but the work being done there is nothing new. Researchers in many European countries have studied the effectiveness of medical heroin for decades, and treatments are commonplace in Denmark, the Netherlands and Germany.

On Friday, researchers from these countries gathered in Vancouver to share the results of their work at the International Symposium on Supervised Injectable Opioid Assisted Treatment.

Their positions were clear: heroin-assisted therapy works. And despite success stories from Crosstown patients like Cooper, Vancouver is lagging behind.

Prescription heroin has been pointed to as a potential fix for the fentanyl overdose crisis that has been ravaging the Vancouver's Downtown Eastside, and affecting people across the country.

Dr. Nicola Metrebian, Dr. Uwe Verthein, and professor Wim van den Brink were among several panellists discussing the merits of prescription heroin. (Jon Hernandez/CBC)

Prescription Heroin

Wim van den Brink of the Netherlands told a news conference that some European programs started as a way to deal with the public nuisance of drug use but the medical health benefits improved people's quality of life and saved money in the criminal justice system.

"There's so much experience locally and internationally, the efficacy is so clear," said van den Brink, a professor of psychiatry and addiction at the University of Amsterdam's Academic Medical Centre.

"I'm not sitting here with some kind of moral superiority that we did it so wonderful. Politically, it wasn't primarily motivated by public-health issues."

Seventeen clinics provide supervised injectable and inhalable heroin for about 800 chronically addicted patients in the Netherlands, he said.

Crosstown Clinic patient Mark Schnell injects his medicated dose of hydromorphone, a heroin replacement, into his shoulder. (Rafferty Baker/CBC)

An opioid crisis

The impetus for the gathering, organized by the Public School of Health at the University of British Columbia, was the estimated 2,000 overdose deaths across the country since 2016, many involving the painkiller fentanyl.

"Even from a medical perspective, this is a cheap treatment if you can save so many lives," van den Brink said. "The only thing is, do we think the lives of addicts are worth the same thing as people with any other disease?"

Senior research fellow, Nicola Metrebian, of the National Addiction Centre at King's College London, said the United Kingdom government funded four clinics in 2012, providing injectable opioid treatment, based on evidence from a major clinical trial there and from international research. But the facilities were forced to close because of a lack of funding.

"We are in a very similar position to you guys in Canada," Metrebian said. "We are still trying to get this into routine treatment."

Dr. Eugenia Oviedo-Joekes was one of the lead researchers of the SALOME project, a pilot that explored the effectiveness of medical-grade heroin at the Crosstown clinic. (CBC file photo)

Eugenia Oviedo-Joekes, an associate professor at the University of British Columbia's School of Public Health, presented two major Canadian studies that led to the opening of the Crosstown Clinic.

Oviedo-Joekes said people who are treated at Crosstown no longer use deadly opioids sold on the street and get help from social workers with issues such as filling out housing applications.

She said the program urgently needs to be expanded. And for patients like Russell Cooper, the fact that it hasn't is troubling.

"We've done the trials. Let's get on with saving lives," he said.

With files from the Canadian Press