Canada Proposes Allowing Prescription Heroin for Opioid Dependence

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.

“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.