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

Klaglahachie goes plaid for new play

Forever Plaid musical to take to Ponoka stage next month

Ponoka locals to compete at CFR

The 2019 Canadian Finals Rodeo (CFR) in Red Deer will feature a… Continue reading

Ponoka town council passes first reading of proposed animal control bylaw

New, updated bylaw would replace old one, includes cats

CBHI doles out the cash

The annual huge barrel racing event in Ponoka another great success

Bantam Broncs better on both sides in big win

Ponoka pounds Lindsay Thurber 38-12 in final regular season home game

Scheer, Trudeau, Singh haggle over potential minority government outcome

If you believe the polls, it appears the Liberals and Conservatives are neck-and-neck

‘The more you test, the more you find’: Beef recalls a sign of success, experts say

Despite appearances, experts say a recent rise in major recalls is not a sign of food supply problems

PODCAST: Journalism instructor discusses how reporters have taken on climate change

Mount Royal University’s Sean Holman has been researching how journalists have covered climate change

ELECTION 2019: Have Justin Trudeau’s Liberals really cut middle-class taxes?

Conservative Andrew Scheer vows to cut bottom bracket, NDP’s Jagmeet Singh targets wealth tax

Alberta truck convoy plans counter-protest at climate rally with Greta Thunberg

United We Roll organizer says similar protest planned for Swedish teen’s event in Edmonton

Maskwacis RCMP truck rammed by fleeing vehicle

An individual has been arrested following a chase and then a deliberate… Continue reading

Alberta takes second look at trucking changes after meeting Broncos families

Transportation minister has said government was reviewing rules for school bus drivers and farmers

Male pedestrian dead after collision with train in Blackfalds

Man from Red Deer pronounced dead at the scene

‘Sky didn’t fall:’ Police, lawyers still adjusting after pot legalization

Statistics Canada says 541 people were charged under the federal Cannabis Act between Oct. 17, 2018 and the end of the year

Most Read