Despite delays, a group of Vancouver addicts is on track to become the first recipients of prescription heroin in Canada before the end of the year.
Adrienne Smith, a lawyer with Pivot Legal Society, told the Straight that regulatory and bureaucratic hurdles have been “complex” and a “slow process”, but that Providence Health Care is confident it has secured all permissions required.
“They expect to be in a position to order the medication any day now,” Smith said in a telephone interview. “And then it takes 55 days to ship, so it’s expected to arrive at the end of the year.”
Prescription heroin or diacetylmorphine will be available at Crosstown Clinic in the Downtown Eastside. In accordance with the terms of an interlocutory injunction, only former participants of an academic study called SALOME will be eligible to receive the drug as a treatment for severe opiate addictions. There are 202 such individuals.
That injunction was granted by the B.C. Supreme Court on May 29, 2014. According to a 34-page decision, Chief Justice Christopher Hinkson found that risks faced by the opiate addicts acting as plaintiffs in the case would be reduced if doctors were allowed to administer prescription heroin.
The judgement notes that to be eligible, patients must have a record of failing to respond to other available treatments for opiate addiction (such as methadone), and that they must be represented by a physician who has filed a Special Access Program application with Health Canada.
Smith expressed concern for patients that have exited the SALOME trial and therefore remain cut off from their supply of prescription heroin until Crosstown Clinic doctors are able to secure and begin administering the drug.
“It’s a slow process, particularly for people who left the study and who are in need of urgent treatment,” she said. “And it’s not a solution for people who did not participate in the study.”
The case first entered the courts on March 25, 2014, when Providence Health Care and five SALOME participants identified as long-time opiate users appeared in the B.C. Supreme Court in an effort to secure diacetylmorphine as a legal means of managing addiction. That action was taken in response to Health Minister Rona Ambrose amending regulations to close what she described as a “loophole” that previously allowed clinicians to prescribe drugs such as heroin, cocaine, and ecstasy (MDMA).
Smith said the next step is to take the legal precedent that permits the administration of heroin for former SALOME participants and hopefully see it applied to allow for doctors to prescribe heroin to all severe users for whom it is deemed an appropriate means of reducing the harm caused by their addictions.
“It will go to a hearing in about a year, which is bad news for folks who would benefit from this treatment in the meantime,” she said. “But we’re told that if we’re successful at trial, prescription diacetylmorphine will be available to every patient who needs it.”