Canada has approved prescription heroin to be given to some patients in an effort to combat the effects of the ongoing opioid crisis. The news comes as some health experts and policymakers in both Canada and the U.S. are looking to implement more harm reduction strategies, which focus on diminishing risk associated with intravenous drug use.
On Friday Canada's health ministry announced that doctors will now be able to prescribe diacetylmorphine or prescription-grade heroin for the treatment of "chronic relapsing opioid dependence." The drugs will be given through Canada's Special Access Programme (SAP) which provides access to drugs not currently available on the market for the treatment patients with serious or life-threatening conditions when "conventional therapies have failed, are unsuitable, or unavailable."
"Scientific evidence supports the medical use of diacetylmorphine for the treatment of chronic relapsing opioid dependence in certain individual cases," Canadian health officials said in a statement sent to ABC News today. "Health Canada recognizes the importance of providing physicians with the power to make evidence-based treatment proposals in these exceptional cases."
Researchers in Canada have been using pilot programs to understand how giving prescription heroin or providing supervised injection sites could affect the health of intravenous drug users. These tactics are part of a harm reduction strategy aimed at reducing the risk surrounding opioid drug abuse without forcing an addict to stop using drugs. In the U.S. similar programs have been considered and the mayor of Ithaca, New York has plans to open the first supervised injection site in the country.
There were record number of deaths related to opioid overdoses in 2014 in the U.S. with 28,000 recorded deaths according to the U.S. Centers for Disease Control and Prevention. In Canada opioid-related deaths have risen sharply and make up half of all drug deaths, according to the Canadian Drug Policy Coalition.
Dr. Scott MacDonald developed a pilot program that studied the effects of providing prescription heroin to certain users in Vancouver and said researchers have seen huge success with the program.
"This is a kind of last resort to get them into care to get them off the streets," MacDonald said. "We see them come to us every day rather than stay on the streets... that engagement and retention in care is a significant benefit."
MacDonald said people who used to to be in and out of jail or the hospital have been able to reconnect with families, go back to school and retain employment.
"That's a major success," he said. In the pilot program users must be a long time heroin user, who has tried at least twice to stop using drugs. The drug users are allowed to come to the clinic between two to three times a day where they are provided a syringe and drugs for injection. Medical staff on site monitor the drug users and can intervene if they show signs of overdose.
Daniel Raymond, policy director for Harm Reduction New York, said that providing prescription heroin could viewed as an extension of medicine-based rehab programs that utilize drugs like morphine or buprenorphine that help medically address symptoms of opioid addiction and withdrawal.
"I think the idea is not so much the Marie Antoniette style let them have heroin," said Raymond. "We know people who struggle with opioid disorder. We've been using bufneoprohine, morphine...none of them have been sufficiently scaled up."
Raymond pointed out this treatment is only right for a small group of drug users.
"What we see from research is a small subset of people with entrenched treatment resistant drug problems," said Raymond. "It seems to stabilize them, it gets them off of the street."
Raymond said a move among health experts and other policy makers towards harm reduction shows a growing awareness that asking drug users to quit drugs isn't always a feasible goal.
"There may be some people who have accumulated a lifetime of trauma," Raymond said. For them "Stability is a goal in and of itself."