Two hundred drug addicts in Montreal and Vancouver will be lining up for free heroin later this year at publicly funded clinics. And they can thank the federal Conservative government, despite its hard line against hard drugs.
The trial - which will offer the drug in pill and injectable forms as well - builds on a similar heroin experiment last year that found most participants committed far fewer crimes and their physical and mental health improved.
The three-year medical trial will put Canada on the leading edge of international addictions research "for a population that is in desperate need for alternate health options," said Michael Krausz, the lead investigator.
But the project is only proceeding with the blessing of, and $1-million in funding from, the Canadian Institutes of Health Research, an agency of Health Canada.
The federal Conservative government is currently fighting Vancouver's supervised-injection facility, Insite, in court. Prime Minister Stephen Harper has argued that taxpayer money should not fund drug use, but should be spent on prevention and treatment.
The heroin trial goes even further than Insite, not only providing a safe place to inject, but also the heroin itself.
The drug is legally purchased in Europe and brought to Canada under armed guard.
The trial is called SALOME, the Study to Assess Longer-term Opioid Medication Effectiveness, and it will build on a similar heroin experiment that wrapped up last summer. The North American Opiate Medication Initiative (NAOMI) was also funded by the Canadian Institutes of Health Research with the approval of Health Canada.
The NAOMI trial was criticized by some addictions physicians but drew no comment from the federal government, which paid more than $8-million for the research.
"It's been disappointing," said Martin Schechter, who led NAOMI and is also working on SALOME. Dr. Schechter said European health authorities are very interested in the work, but Canadian authorities will not acknowledge it.
"There's a lot invested in NAOMI. We did everything we could to translate the information for decision-makers to make them understand what it meant," he said.
Dr. Krausz, a leading addictions researcher, has conducted another heroin trial in Germany, the largest such randomized clinical trial in Europe.
The Canadian research aims to determine if medically prescribed heroin is a safe and effective treatment and if users will accept the drug in pill form instead of injecting it.. It will also measure whether a licenced narcotic, Hydromorphone, can be used instead of heroin.
His team is now recruiting about 200 severe heroin addicts who have failed to respond to existing treatments and they expect to have the clinics in Vancouver and Montreal open by this fall.
Last week, Dr. Krausz's medical team sat down with Vancouver philanthropists asking for additional support for the clinics that will distribute both heroin and a legal narcotic substitute to hard-core addicts. Organizers say one business leader immediately offered a cheque for $100,000.
Trish Walsh, executive director of the InnerChange Foundation, who arranged last week's fundraiser with top Vancouver business and community leaders, said the 30 people who gathered in a corporate boardroom understood that the city cannot ignore its drug-addicted population.
"We have been sleepwalking right through the middle of this crisis."
Health Minister Leona Aglukkaq did not return calls, but her press secretary, Josée Bellemare, offered an e-mailed statement on the minister's behalf: "Our government recognizes that injection drug users need assistance. That's why we are investing in prevention and treatment, to help people recover from their drug addictions."