Vancouver, one of North America's most progressive cities in respect to drug policy, will conduct a groundbreaking experiment: prescription heroin.
Following a clinical trial involving 26 subjects, doctors at the city's Providence Medical Clinic have earned permission to provide doses of the drug to a group of 120 severe addicts. The decision followed a lengthy back and forth with Rona Ambrose, Canada's federal Health Secretary, who opposes the policy.
Vancouver has provided needle-exchange programs since 1988, a policy that has reduced negative outcomes from contaminated needles. But clean needles may not be enough. In recent months, several dozen addicts have overdosed on heroin at the clinic, usually through using street-purchased drugs. The prevalence of the overdoses—there were 31 over a two-day period in October—led drug-policy experts to recommend more progressive policies to combat the negative effects of the drugs.
Traditionally, doctors have prescribed methadone as a substitute for heroin addicts, and the substance will continue to play a major role in treatment. But 15 to 25 percent of heroin addicts fail to respond to methadone.
"Methadone works decently well," the reporter Ben Carey told The New York Times' John Tierney in 2009, "but a lot of addicts just don’t like it, so they don’t go in and get treatment."
Will Vancouver's experiment work? Studies conducted in Europe—where prescription heroin is common—reveal that the programs have produced improved public-health outcomes as well as reduced crime. Prescription narcotic abuse has been a significant problem in the United States, and heroin abuse is a large and growing problem in the country. A recent study from the Center on Disease Control found that heroin use increased 74 percent from 2009 to 2012, and that in 2012 Americans were twice as likely to suffer a fatal overdose than they were in 2010.
While the success of Vancouver's experiment is far from assured, the city's willingness to offer prescription heroin reflects a willingness to provide new opportunities for beleaguered addicts.
"Everyone has a different path and people need different options," Laura Thomas, the Drug Policy Alliance, told The Daily Beast.