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Canada Proposes Allowing Prescription Heroin for Opioid Dependence

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The Canadian government has taken the first tentative step toward legalizing prescription heroin. Health Canada, the country’s federal health agency, announced Friday that it has plans to propose a regulatory amendment that would give some drug users access to diacetylmorphine—heroin—prescriptions.
“A significant body of scientific evidence supports the medical use of diacetylmorphine, also known as pharmaceutical-grade heroin, for the treatment of chronic relapsing opioid dependence,” the health agency said in a news release.
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“Diacetylmorphine is permitted in a number of other jurisdictions, such as Germany, the Netherlands, Denmark, and Switzerland, to support a small percentage of patients who have not responded to other treatment options, such as methadone and buprenorphine.”
Under the proposed change, heroin would move into a different category of controlled substance—one that would allow it to be considered for use in the Special Access Programme, or SAP. Through SAP, patients with serious or life-threatening conditions can put in requests for emergency access to certain drugs when more conventional approaches have failed.
Thus, if methadone or buprenorphine don’t seem to be working for a patient, they might be able to put in a request to SAP. The request would then be evaluated by federal clinical experts, who would decide whether or not to offer a stamp of approval for heroin maintenance treatment on a case-by-case basis.
Providence Health Care—the operator of Crosstown Clinic, which already operated a heroin maintenance program for a clinical study—lauded the move.
“Allowing access to diacetylmorphine, or medical heroin, to patients who need it, ensures that life-saving treatments get delivered to vulnerable people suffering from chronic opioid use,” Providence said in a statement, according to the Vancouver Sun.
Dr. Scott MacDonald, a physician with the Crosstown Clinic, said that heroin maintenance programs are cheaper for taxpayers than unchecked addiction. One person battling a drug addiction can cost the tax base more than $45,000 in Canadian dollars (around $35,000 in U.S. dollars) per year in crime, court costs, health care, and more, he said. Prescription heroin administration at the Vancouver clinic costs around $27,000 per year, or $21,000 in American money.
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