Five-milligram pills of Oxycodone. (AP Photo/Keith Srakocic, File)

Give severely addicted drug users injectable medical-grade heroin, guideline says

CMAJ article outlines best practices for innovative treatment that’s been lacking in overdose crisis

A national research group recommends that health-care providers offer injectable medical-grade heroin or other prescription drug to severely addicted patients if oral medication has not worked to reduce cravings for people who could die from toxic street drugs.

Dr. Nadia Fairbairn, an addiction specialist at St. Paul’s Hospital, said a guideline published Monday in the Canadian Medical Association Journal outlines best practices for innovative treatment that has been lacking during an overdose crisis that claimed 4,460 lives in Canada last year.

“I think we really are going to need to think about how history’s going to look back on this era where we’re losing so many Canadians to a totally preventable cause like opioid fatalities,” said Fairbairn, the lead investigator for the Canadian Research Initiative on Substance Misuse, a research consortium.

Key recommendations in the guideline include the use of the injectable opioids diacetylmorphine, or pharmaceutical-grade heroin, and hydromorphone for patients who shoot up illicit opioids and have not responded to the most effective oral treatments — methadone and buprenorphine.

The Crosstown Clinic in Vancouver is the only facility in North America that provides diacetylmorphine, which is imported from Switzerland, as well as hydromorphone, another safer substitute for heroin recommended by the initiative, which consists of 32 members including Canadian health-care practitioners, opioid users and their families.

The Vancouver-based Study to Assess Longer-term Opioid Medication Effectiveness, published in 2016 in the Journal of the American Medical Association Psychiatry, found injectable hydromorphone and diacetylmorphine are equally effective at treating severely addicted heroin users who don’t respond to oral therapy. It included 202 patients.

An earlier study, the North American Opiate Mediation Initiative, which took place in Vancouver and Montreal between 2005 and 2008, suggested diacetylmorphine is an effective treatment for chronic heroin users when methadone does not work.

The recommendations are a blueprint for health-care practitioners on screening patients who would benefit from injecting the two injectable opioids under medical supervision, said Fairbairn, who is also a research scientist at the BC Centre on Substance Use.

Hydromorphone is also provided at a limited number of other clinics in B.C., some of which provide pills that users crush before injecting.

Dr. Scott MacDonald, the lead physician at the Crosstown Clinic, said the heroin substitute is available at about 10 clinics across Canada for chronic injection-drug users.

He said 125 patients are registered to inject diacetylmorphine at Crosstown, and 25 people are given hydromorphone.

READ MORE: How to talk to kids about B.C.’s overdose crisis

The rigorous program requires patients to inject at the facility under medical supervision three times a day at an annual taxpayer-funded cost of about $27,000 per patient, MacDonald said.

Overall societal costs would be higher if chronic drug users continued committing crimes to get their fix, raising policing levels and using health-care resources from overdosing or getting infections from used needles, he said.

“If we’re able to show that a new treatment is both more effective and more cost-effective it should be expanded. That should be an easy decision for health-care decision-makers, just looking solely at the evidence.”

The Canadian Press

Like us on Facebook and follow us on Twitter

Just Posted

‘Very disrespectful’: Cariboo first responder irked by motorists recording collisions on cellphones

Central Cariboo Search and Rescue deputy chief challenges motorists to break the habit

BC Cannabis Stores set to open in Williams Lake Nov. 27

BC Cannabis Stores is slated to open for business at 10 a.m. next Wednesday, Nov. 27.

Burning of debris piles scheduled for Kleena Kleene area to restore 2017 fireguards

Smoke may be visible from Highway 20 and from neighbouring communities

William Griffin arrested in Houston homicide

RCMP have now arrested William Griffin, the man wanted in connection to… Continue reading

Bye bye Bei Bei: Giant panda born in U.S. zoo heads to China

Panda heads back to China as part of cooperative breeding program

B.C. to advocate for frustrated, confused, unhappy cellphone users, says premier

Maple Ridge New Democrat Bob D’Eith to advocate for more affordable and transparent cellphone options

B.C. man who killed Belgian tourist near Boston Bar gets life in prison, no parole until 2042

Sean McKenzie pleaded guilty to second-degree murder of 28-year-old Amelie Christelle Sakkalis

Daily cannabis linked to reduction in opioid use: B.C. researchers

Researchers looked at a group of 1,152 people in Vancouver who reported substance use and chronic pain

Bids down, costs up on Highway 1, B.C. independent contractors say

Rally protests NDP government’s union-only public construction

Members of little people community applaud change to drop ‘midget’ term

‘It’s not about sensitivity,’ says Allan Redford, the president of the Little People of Canada

Little progress in preventing sudden infant deaths since last report: BC Coroner

Coroners panel studied 141 sleep-related sudden infant deaths between 2013 and 2018

B.C.’s ‘Dr. Frankenstein of guns’ back in jail yet again for trafficking in Glock parts

Bradley Michael Friesen has parole revoked for allegedly importing gun parts yet again

Most Read