Opinion

Latest in Tory Rejections of Science: Ban on Prescription Heroin

Treatment proven to help hardcore addicts shunned by our evidence-averse government.

By Bill Tieleman, 22 Oct 2013, TheTyee.ca

Diamorphine prescription

For a particularly difficult-to-treat group of patients, studies in six different countries found prescription heroin can help. Photo: Wikipedia, public domain.

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"I think it's ethically quite dubious to withhold access to a scientifically proven treatment." -- BC provincial health officer Dr. Perry Kendall

The science supporting doctor-prescribed heroin for severe addicts is strong, including extensive medical reports from six countries in tests involving over 1,500 patients.

But for the federal Conservative government, ideology will always be grounds to reject science, research, evidence and experts.

The latest example? Health Canada recently approved a pilot research program in Vancouver involving just 16 hardcore heroin addicts who haven't yet found help through either methadone treatment or residential rehabilitation. For the study, medicinal heroin was to be prescribed and safely administered by doctors.

The goals: improve addicts' health, reduce criminal activity, cut harm from street drugs, and potentially give them a chance to eventually kick heroin.

But once the approval came to light, Conservative Health Minister Rona Ambrose flew off the handle and said no way, attacking her own ministry by news release.

"Our policy is to take heroin out of the hands of addicts, not to put it into their arms," Ambrose fumed.

That was swiftly followed the next morning by a fundraising email to Conservative Party donors, claiming Health Canada had broken "the wishes of our elected government."

And a petition appeared on a Conservative website urging signatures to "Stop giving heroin to addicts."

Can you spell opportunistic politics?

Controversial, but clearly effective

Last week's throne speech kept up the anti-science, we-know-better-than-doctors-and scientists drumbeat.

"Our government will... close loopholes that allow for the feeding of addiction under the guise of treatment," the speech read.

But rigorous medical research clearly shows the troubled Tories are simply wrong.

Hardcore addicts can be helped by prescription heroin, a 176-page scientific report on the results of pilot studies in six countries involving 1,500 patients says.

Issued by the European Monitoring Centre for Drugs and Drug Addiction, the report admits that doctors prescribing heroin to severely addicted patients can at first seem "counterintuitive" and "controversial" but the results are clear.

"Internationally, a number of experimental projects using robust research designs have been beginning to suggest that for some of those failing to respond to other approaches, the use of diamorphine as a substitution medicine may be an effective way forward," it says.

"This is not simply a case of giving heroin to heroin addicts. Rather, studies have looked at the use of heroin as part of a highly regulated treatment regime, targeting a particularly difficult-to-treat group of patients," it continues.

Mixing poppies with politics

But science be darned -- that's the view of right-wing strategists like Rod Love, a federal Conservative supporter and political consultant who was ex-Alberta premier Ralph Klein's right-hand man.

I debated Love and National Post columnist Barbara Kay on CBC Radio's The 180 with host Jim Brown and the results were eye-opening.

Here's one exchange, after I pointed out that just 16 addicts had received Health Canada approval for prescription heroin before Ambrose vetoed it and that the European studies results were scientifically solid:

Rod Love: "What the minister said clearly was that so it's only 16 -- it is inconsistent with the government's anti-drug policy in her opinion and she makes the decisions in this respect, not some report from Europe with..."

Bill Tieleman: "Doctors and scientists?"

Rod Love: "Yeah."

Bill Tieleman: "We don't want doctors and scientists telling this government what to do. They don't listen to scientists anyway, Rod, we've already proved that over and over on the environment!"

Barbara Kay: "I think that when you introduce these 'It's only for a very tiny group of people' -- it's the same thing that they said with euthanasia -- it's only for a very tiny group of people. Now in Belgium they're like, you know, euthanizing 14 year olds for depression.

"I think this is a slippery slope and the ideology behind it is the wish to legalize hard drugs. This is a gateway opening towards that."

Bill Tieleman: "If your values trump my science, I don't want to see that, I don't think that's correct... if the science proves and the doctors say it's working, we should listen to them and not to ministers doing it for political reasons."

Fortunately, others are taking on Ambrose's kneejerk approach.

BC Liberal Health Minister Terry Lake: "We're reluctant to close the door on innovation and creativity when it comes to tackling these very challenging problems. We have to think out of the box sometimes… I know that the thought of using heroin as a treatment is scary for people, but I think we have to take the emotions out of it and let science inform the discussion.

Respected Vancouver medical doctor and author Gabor Mate in an open letter to Ambrose: "In the absence of medically provided heroin in a safe environment, such unfortunate individuals will continue to seek illegal sources of drugs, potentially impure, and inject them under frequently unsafe circumstances. The resulting illness, overdose, and deaths are surely not outcomes you would desire."

And B.C.'s provincial health officer Dr. Perry Kendall: "This is an accepted treatment practice in several advanced countries in the world. And I think it's ethically quite dubious to withhold access to a scientifically proven treatment."

Of course, the Conservatives aren't objecting to another drug created with the same opium poppies that heroin comes from. Prescription morphine is used widely for the effective treatment of chronic or temporary pain by hundreds of thousands of Canadians without any Conservative objections.

In fact, one in six Canadians over 15 years of age used some form of opioid pain reliever in the previous 12 months, according to a 2011 Health Canada survey.

Which all goes to show how poppies and politics don't mix.

Prescribing heroin for heroin addicts may seem counterintuitive, but using science-based evidence should not be -- even for this Conservative government.  [Tyee]

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