- VANCOUVER -- On a warm, rainy
Saturday morning, Debbie Woelke stops pushing her shopping cart long enough
to discuss the pros and cons of a plan to give free heroin to drug addicts
in Canada's poorest neighbourhood. The heroin trial is all the talk of
Vancouver's Downtown Eastside and Ms. Woelke, 48, thinks it's a good idea.
She might even apply, herself. "They should have done this a long
time ago," she said leaning on her cart, which contains all her
worldly
belongings -- not groceries.
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- Like other addicts, Ms. Woelke lives in a bleak rented
room in a residential hotel. Far better to be outside in the rain, even
if it means wheeling around your clothes all day.
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- "Sometimes you need something just to relax and
get your mind together, instead of always being in a state of panic. That's
what's killing everyone down here," she said, pointing to the throngs
of bedraggled souls shuffling along East Hastings Street. Like Ms. Woelke,
they must hit the pavement every day to raise enough cash for their drugs.
Most steal. Many women work as prostitutes.
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- "They have to do things they wouldn't normally
do."
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- This is exactly what some of Canada's top addiction
experts
want to find out when they begin the first heroin prescription trial in
North America.
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- If heroin addicts are freed of their daily chase for
drugs, if it is given to them three times a day like medicine, can they
change their lives for the better?
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- In a couple of weeks, the research team will begin taking
applications here in Vancouver and later in Toronto and Montreal from
addicts
who want to be part of the study.
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- Researchers are looking for hard-core addicts, people
who have tried and failed at least twice to get clean. In the three cities,
there are spots for 428 addicts, roughly half of whom will receive heroin
for a year; the other half will receive methadone, an artificial opiate
that controls the cravings for heroin.
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- In Vancouver, the trials are causing a stir on the
syringe-littered
streets of the city's skid row, home to more than 4,000 drug users. Among
those who deal first hand with these chaotic lives, there's a feeling that
Canada is breaking new ground in how it treats the most intractable of
drug addictions.
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- Similar studies in the Netherlands and Switzerland have
shown positive results for addicts.
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- "What if you could say to an addict, 'For the next
little while, you're not going to have to get your drugs from Al Capone.
You can get your drugs from Marcus Welby,' " said Dr. Martin
Schechter,
the project's lead researcher.
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- "You don't have to worry about this afternoon and
this evening. And therefore, you don't have to go and break in to cars
or be a prostitute. You could actually come and talk to a counsellor or
. . . get some skills training."
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- It's a landmark study in North America, one that turns
its back on abstinence as the goal.
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- But not everyone is thrilled with the prospect of free
heroin for hard-core addicts. And even supporters have expressed concern
about the ethics of offering heroin to addicts for a prescribed period
of time. Is it fair to yank away their heroin at the end of the
year?
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- Addiction experts in Canada have already expressed
concerns
about the risk of overdoses.
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- Last December, two staff physicians at Toronto's Centre
for Addiction and Mental Health wrote scathing critiques to the ethics
adviser of the Canadian Institutes of Health Research, the agency funding
the study.
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- Vancouver physician Stanley deVlaming is worried the
trials are designed to garner positive results. In Vancouver, 88 subjects
are to receive heroin, while 70 will receive methadone, the heroin
substitute.
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- "How meaningful will it be to compare the group
of 88 elated subjects that win the heroin lottery to the group of 70 who
were also desperately trying to get the free heroin, but lost the luck
of the draw?" asked Dr. deVlaming, who has treated addicts in the
Downtown Eastside for more than a dozen years.
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- "The first group would likely be very motivated
to give the researchers positive results, while the second disappointed
and disgruntled group randomized to methadone would be much less
motivated."
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- As expected, the plan has rankled U.S. drug officials,
specifically the office of White House drug czar John Walters, where an
official called it an unethical and "inhumane medical
experiment."
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- Offering free heroin to addicts when there are proven
treatments for addiction can't be justified if the addict's desire is to
get off drugs, policy analyst David Murray said.
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- "What you're doing is making it easier to be a
heroin
addict," he said from Washington. "These people won't get that
much better in the long run. They will still be heroin
addicts."
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- Washington's disapproval was expected and hasn't deterred
Ottawa from funding the study. The Canadian Institutes of Health Research
has committed $8.1-million for the trials.
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- In Vancouver, the plan has the support of top politicians
and law enforcers, including the mayor and the police chief.
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- Mayor Larry Campbell, who was once a coroner and drug
cop, said the trials are needed because current treatments aren't working
for hard-core addicts.
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- "The critical thing is to accept this as a medical
condition," Mr. Campbell said.
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- "The side effects of this medical condition is that
it forces you to . . . do things that you would never do, be it work as
a sex-trade worker, be a B and E [break-and-enter] artist or a purse
snatcher.
So if I can mitigate that by putting you on heroin, imagine the changes
you could have."
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- Right now, the trial is waiting for Health Canada to
grant the necessary exemption form the Canadian Narcotics Act.
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- Ms. Woelke said she plans to tell her friends to apply.
She would be content to get on the methadone program.
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- "Methadone, whatever," she said shrugging her
shoulders. "I need something every day."
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