B.C. doctors given Health Canada approval to prescribe heroin



ANDREA WOO
The Globe and Mail

VANCOUVER — After years of petitioning by health officials in British Columbia, Health Canada has authorized some B.C. doctors to prescribe heroin for select patients who have failed to respond to conventional opioid addiction treatments. But within moments of the authorization, Federal Health Minister Rona Ambrose blasted the department’s decision, saying it flies in the face of the Conservative government’s anti-drug policy, and vowed to ensure it never happens again. Health Canada on Friday authorized doctors to prescribe heroin to around 15 patients, The Globe and Mail has learned. The doctors had applied to Health Canada under its Special Access Programme (SAP), which grants doctors access to non-marketed or otherwise unapproved drugs for patients with “serious or life-threatening conditions when conventional therapies have failed, are unsuitable or unavailable,” according to a description on Health Canada’s website.

Health Canada on Friday authorized doctors to prescribe heroin to around 15 patients, The Globe and Mail has learned. The doctors had applied to Health Canada under its Special Access Programme (SAP), which grants doctors access to non-marketed or otherwise unapproved drugs for patients with “serious or life-threatening conditions when conventional therapies have failed, are unsuitable or unavailable,” according to a description on Health Canada’s website.

Ms. Ambrose said in a statement the decision simply “allows [the addicts] to continue to have access to heroin for their addiction even though other safe treatments for heroin addiction, such as methadone, are available.”

The doctors had recently renewed their calls for allowing prescription heroin in light of the ongoing SALOME trial, a three-year project launched by researchers from Providence Health Care and the University of British Columbia to determine whether hydromorphone – a powerful but legal opiate – is as effective as diacetylmorphine (prescription heroin) in helping severely addicted heroin users.

A previous study (NAOMI) by the same researchers, published in the New England Journal of Medicine, had concluded prescription heroin is a safe and effective treatment for the small subsection of addicts who did not benefit from conventional treatments such as methadone. Participants who took prescription heroin were more likely to stay in treatment, reduce illegal drug use and avoid illegal activities, researchers found.

In both studies, doctors were concerned by the lack of an exit strategy once participants had completed their 13-month trials. While some patients could not differentiate between hydromorphone and prescription heroin – suggesting hydromorphone could be an effective, legal substitute for heroin – doctors are reluctant to prescribe the former as NAOMI is not yet complete. That means there is no conclusive evidence to show hydromorphone – a pain medication – is an effective treatment for heroin addiction.

Patricia Daly, chief medical health officer and vice-president of public health at Vancouver Coastal Health, was one of several doctors who wrote to Health Canada.

“I’ve written to Health Canada and asked that [the patients] be allowed to get injectable diacetylmorphine – that’s injectable heroin – because we’ve demonstrated in a research study, published in the New England Journal, that’s an effective treatment,” she told The Globe earlier this month.

Ms. Ambrose said Health Canada’s authorization “is in direct opposition to the government’s anti-drug policy and violates the spirit and intent of the SAP.

“I am taking immediate action to protect the integrity of the SAP and ensure this does not happen again,” she said in the statement. “The SAP was designed to treat unusual cases and medical emergencies; it was not intended as a way to give illicit drugs to drug addicts.”

The story continues: http://www.theglobeandmail.com/news/british-columbia/bc-doctors-given-health-canada-approval-to-prescribe-heroin/article14450664/
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Comments

That's fantastic.

Slowly, the fascist walls of this war on drugs have begun to crumble.

Harper and his hidden agenda Conservatives know their ulterior motive anti-drug policies have begun to lose their sway. In the face of new or recent, science-driven, factual ideology, adults of all ages who once stubbornly walked and talked the path of the Conservative, have begun to embrace the truth. And I rejoice for being alive to witness the recent events of late which have contributed to slowly but surely undermining this 40+ year-old war on drug users which has caused untold amounts of irreparable damage since its inception, ironically by a crooked president.

I optimistically await the day, when no one has their freedom snatched away because they felt the need to self-medicate or experiment with a psychotropic substance. A day when we shall look upon the so-called "war on drugs" in bemusement and sadness at the hands of capitalist hypocrites who where in a position to stop or avoid this altogether, but rather chose to look the other way because of the 'financial benefits' awaiting them.

Lastly, one day, I hope that those in power who would choose to break their promises during elections, particularly in relation to drug policy reform, are impeached and banned for the rest of their lives from politics in general.

Edit - I seriously need to relocate to Vancouver. I grow tired of Toronto. Partly because the Leafs continue to suck.
 
Hopefully the patients who get prescribed heroin will utilize it as a maintenance medication and stay in treatment. I doubt this would happen in my lifetime in the United States, but it is nice to hear that science and facts are prevailing in the horribly misguided world of drug addiction and drug addiction treatment.
 
Take it from a Canadian, Rona Ambrose is one epic cunted cunt. It's like if Ann Coulter had power, it sickened me to get my GST cheques signed by her when she was in a ministry more fitting to her, I think it was related to MONEY.

And due to canadian provinces's powers, this won't be spread over Canada obviously, Montreal just got the same kind of safe injection area as Vancouver about 13 years later and it's much smaller (gotta agree there is less of an heroin problem here).

And here I am, suffering multiple health problems from the methadone I took for 11 months (fucked testo, cortisol, massive fattening) and suboxone so far is okay, but I wish I could have just gotten heroin instead, I was slamming hydromorphone by the bucketload before getting there, information gathered on this site and others and even this study suggests hydromorphone is about equipotent to heroin, and heroin lasts way longer apparently. I'm sorry but giving somebody a morphinan type opiate is most likely the best way to have someone getting trouble buying it from organized crime, not having food, destroying their lives etc. Cos once you have tasted the morphine in your veins that many time, you know anything else is a waste of time, it's not you who does, it's your subconscious.
 
IIRC, Switzerland has been using diacetylmorphine as a means of opioid maintenance treatment for those who do not respond well to methadone since 1989. Yeah...

Edit - And the program apparently is a huge success.

Unfortunately, cultural taboos in North America seem to influence opinions regarding recreational drug use in general more so than science, studies, etc. Lately however, it appears that is beginning to change.
 
Here's a comment from the article:

It's been done in Europe with some success so why not here? Come to think of it I'd rather my taxes pay for some heroin to keep from have my my house broken into by someone trying to support their drug habit.
I wish taxes weren't part of the debate here. Like, I wish they would first legalize heroin maintenance and then decide whether or not they want to pay for it. The libertarian-minded demographic is torn between the people who want the government out of their medicine cabinet and the people who want the government out of their wallet.
 
I have thought for a long time that it should be available for terminally ill people especially if nothing else helps their pain. my grandma died a very painful death from ovarian cancer that eventually spread everywhere else it was so had to watch and i wished she could get some heroin prescribed. It's like if you are going to die in a few months anyway who cares if you get addicted? I am not sure i agree with giving it to people with a longer life expectancy... guess i would need to read more about why its being done to say either way
 
bluemonkey;11845279 said:
It's like if you are going to die in a few months anyway who cares if you get addicted? I am not sure i agree with giving it to people with a longer life expectancy... guess i would need to read more about why its being done to say either way
I think that's the point of treating pain due to a terminal illness. Keeping the patient as comfortable as possible without regard for abuse liability because of impending death.

One of the most painful (and disturbing I might add) ways to go from what I understand is Acute Radiation Sickness/Poisoning. If the patient has received a fatal dosage of (usually gamma) radiation, there is not much doctors can do other than pumping the poor soul full of morphine + a potent anti-emetic, and perhaps a benzodiazepine due to patient anxiety related to the illness.

I cannot back this up with sources, but I believe I've read somewhere that in the UK, cases such as the one above may warrant analgesic treatment with diacetylmorphine hcl.
 
bluemonkey;11845279 said:
I have thought for a long time that it should be available for terminally ill people especially if nothing else helps their pain. my grandma died a very painful death from ovarian cancer that eventually spread everywhere else it was so had to watch and i wished she could get some heroin prescribed. It's like if you are going to die in a few months anyway who cares if you get addicted? I am not sure i agree with giving it to people with a longer life expectancy... guess i would need to read more about why its being done to say either way
I can understand peoples reservations about it if they are not familiar with pain mangmnt. But if you are talking about heroin for pain management then giving it to non-terminal pain chronic patients is no different than giving them other opiate/opioid around the clock pain meds. We become dependent on these the same as we would heroin.

I hate it for your grandma..that is terrible. Did they not have hospice care available to her? Are you in the US? It always astounds me when I hear of terminal patients still being in severe pain at end of life. That is what hospice is designed for and when it is utilized they will make sure that the dying patient is not in pain no matter how much or what medications are required. (If they don't then they have not done their job or accomplished their mission).

As a nurse (and I have worked hospice for many years throughout my 20 years of experience) I can say that in this day and age there is no excuse for anyone who is dying to suffer. With enough of the right types of meds there is no pain that cannot be brought under control (the patient may be unconscious...but they won't suffer).
 
ro4eva;11844221 said:
IIRC, Switzerland has been using diacetylmorphine as a means of opioid maintenance treatment for those who do not respond well to methadone since 1989. Yeah...

Edit - And the program apparently is a huge success.

Unfortunately, cultural taboos in North America seem to influence opinions regarding recreational drug use in general more so than science, studies, etc. Lately however, it appears that is beginning to change.

Yep also MS-Contin and then a slow taper....I don't get why methadone would be better really, give a guy a 130mg+ Morphine pill and even if swallowed and he/she was shooting up it will keep them well for 12 hours, they can use the 200mg ones to start with. Methadone is ...ugh...I think they stick to the theory (in america/canada/uk) with the racemic methadone that the ndma antagonism of d-methadone is desirable in rewiring the brain back to a virgin state blah blah everyone here read about how nmda antagonists play with tolerance. Which I guess is true,during the last part of my methadone treatment before switching to subs, I'd sometimes skip days, eat a 100mg/130mg Kadian (another kind of MS-Contin...they're more like Hydromorph Contins, gelcaps, beads) with tagamet and bam, sure it is 600mg rx only, well all strengths are rx only here since a long time) and I was ok with that, the natural way it gets you is so much more desirable and what is making me people using heroin want to keep using...nothing like god's fucking medecine, if it was grown unrestricted everywhere, we'd likely not have a very advanced society but damn, would anyone even care ? lol

Alright, time to take my suboxone like a good boy and kill the junkie in me ¬_¬

ro4eva;11845449 said:
I think that's the point of treating pain due to a terminal illness. Keeping the patient as comfortable as possible without regard for abuse liability because of impending death.

One of the most painful (and disturbing I might add) ways to go from what I understand is Acute Radiation Sickness/Poisoning. If the patient has received a fatal dosage of (usually gamma) radiation, there is not much doctors can do other than pumping the poor soul full of morphine + a potent anti-emetic, and perhaps a benzodiazepine due to patient anxiety related to the illness.

I cannot back this up with sources, but I believe I've read somewhere that in the UK, cases such as the one above may warrant analgesic treatment with diacetylmorphine hcl.
Yeah,same for Canada, when the 50mg/ml hydromorphone solution doesn't cut it anymore, heroin is indeed available as last resort, as well as ketamine.I know a person who knows a person who's uncle (I met the persone who confirmed it too...he didn't die.....his skin in the back and on the legs is horrifying still and he was getting shots of both, floating over his body due to the ketamine and he was thinking...well, now would be the time to die before this stops acting.
 
We had a very small pilot scheme in the UK to prescribe diamorphine to addicts. Many of them led healthy and productive lives, none of them resorted to crime. A policy like this could fucking work, and it pisses me off my government pulled the plug.
 
Well this is a small step in the right direction. Too bad it will be awile if ever until it becomes nationwide. I don't know why they just don't offer morphine as a substitute as it would fix the addict up fine and dandy, if you could get them off the needle and onto the SR form that would be convenient twice a day dosing and unlike diamorphine it's used all the time in Canada. It can be easily used off label and i have heard a few cases where this was done with both morphine SR's and Oxycontin. Giving people shots of hydromorphone would be a bad idea though in my opinion. In my experience it drives my tolerance through the roof and i can easily shoot 54mg's of hydromorphone in a shot. The rush is just so intense and the high is so short lived.

Diamorphine used to be used in Canada for pain but i guess due to the stigma and most likely cheaper drugs it's not anymore. It was manufactured by Technilab Pharma right up until 1997 but was discontinued by the company. With drugs like hydromorphone and fentanyl available for acute and chronic pain there isn't as much need for Heroin as use for a pain killer. I know that in the UK it's becoming more commonly used to treat acute pain in hospital settings especially since Pethidine has been for the most part phased out.
 
Addiction treatments never cease to amaze me, Sure if someone is in acute pain then go ahead and give them whatever they need for relief, but if someone is hitting themselves on the head with a hammer, doesn't it make more sense just to keep them away from all hammers for a while until they mentally stabilize ?
 
Fair enough, but we're living in a free society; if the state fails to provide a substitute to these people, they will use far more risky drugs at a much higher cost to society. Giving substitute drugs to addicts is a pragmatic policy; it saves the government a HUGE amount of money (I'm talking about law enforcement here).

Addicts will get the drugs they need one way or the other; there isn't a free society on the planet that can prevent people from using drugs on a mass scale.
 
paranoid android;11849482 said:
Well this is a small step in the right direction. Too bad it will be awile if ever until it becomes nationwide. I don't know why they just don't offer morphine as a substitute as it would fix the addict up fine and dandy, if you could get them off the needle and onto the SR form that would be convenient twice a day dosing and unlike diamorphine it's used all the time in Canada. It can be easily used off label and i have heard a few cases where this was done with both morphine SR's and Oxycontin. Giving people shots of hydromorphone would be a bad idea though in my opinion. In my experience it drives my tolerance through the roof and i can easily shoot 54mg's of hydromorphone in a shot. The rush is just so intense and the high is so short lived.

Diamorphine used to be used in Canada for pain but i guess due to the stigma and most likely cheaper drugs it's not anymore. It was manufactured by Technilab Pharma right up until 1997 but was discontinued by the company. With drugs like hydromorphone and fentanyl available for acute and chronic pain there isn't as much need for Heroin as use for a pain killer. I know that in the UK it's becoming more commonly used to treat acute pain in hospital settings especially since Pethidine has been for the most part phased out.
The burn ward person I know of had this accident in the late 90's...might have been '98 so maybe it was remaining stocks in the hospital but I know the doctor told him something like : "We'll get you something that is locked here only for very very unlucky people like you."
 
sorry but i gotta be pesimistic bout this... 15 patients??? thats all? fucking bullshit that they only allow the most desperate access to this program. so what now? you gonna have methadone patients "failing" on purpose to get on scripts for down? just fucking realize that if we (society) are willing to script opiates for opiate addicts just give them their DOC. if an addict prefers hydromorphone to oxy, or codeine to diamorphine, just give them their DOC for fuck sakes... fucking harper and his goons...
 
Exactly: What the hells wrong with prescribing an addict their drug of choice? The way I see it, current substitutes are arguably inferior, cost more, and can be far harder to get off, owing to their extremely long half-life's (compared to diamorphine for example, making a relapse to their original drug of choice more than likely; I spent 3 weeks without bupe, and ran back to my DOC without hesitation...months of withdrawal can really destroy your resolve imo wheras with diamorphine, you're talking 3-5 days.
 
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