VANCOUVER, BRITISH COLUMBIA — The Providence Health Care Society provides addicts with small amounts of controlled injections that changes how the 110 patients at its Crosstown Clinic are spending their days. Instead of overdosing and becoming fatality statistics, or turning to various crimes to purchase street drugs, they are getting to work and reconnecting with family because of their heroin prescriptions.
To be part of the heroin prescriptions program, the patients must have a five-year history of abuse, two failed attempts at replacement therapy such as methadone and participated in one of two clinical trials. The clinic, which opened in 2005, is the only facility in North America that can legally prescribe diacetylmorphine hydrochloride, the active ingredient in heroin. The clinic reported the average dose is about 200 milligrams.
The heroin prescriptions program is different because while legal injection sites (outside the U.S.) and clean needle programs have been shown to help lower fatalities and reduce disease, they do not address what addicts do to purchase their drugs. The injection sites also do not control what’s injected; users bring in their own substances. Heroin is often be mixed with fentanyl, a more potent opioid.
In some U.S. cities, like Boston, heroin addicts are so afraid of overdose, they shoot up in hospital bathrooms so they can tie emergency pull cords to themselves so alarms will sound if they do.
The Crosstown Clinic patients in Vancouver don’t have to worry about the purity of what they view as life-saving medicine for the disease of addiction. Larry Love, a 65-year old program participant, who started shooting heroin at 13, compared his heroin prescription to insulin injections diabetics need daily to live.
“It’s 100 percent about stability,” he said. “Now I have money in my savings account and can get a haircut whenever I want. I’ve even started investing.”
According to the New York Times, the program costs Vancouver taxpayers $21,000 per year for each patient. But in a related 2012 study, opioid users run taxpayers about $35,000 in medical treatment and incarceration costs.
Proponents would like to extend the program, but Canadian federal regulations currently stand in the way. In October, the Supreme Court of British Columbia is scheduled to consider if the regulations violate the constitutional rights of heroin addicts in a suit brought by the Providence Health Care Society and some of the Crosstown Clinic patients. The court ruled the patients can continue to receive their prescribed injections until the case is decided.