Peter McKnight is an adjunct professor in the School of Criminology at Simon Fraser University.
If you've ever had surgery, you owe a debt to heroin-assisted therapy, and not because you were probably doped up on morphine in post-op.
Rather, it's because of William Halsted. Appointed the first chief of surgery of Johns Hopkins in 1889, the man now known as "the father of surgery" proceeded to revolutionize the craft during his more than 30-year career. Among other things, Mr. Halsted introduced the use of surgical gloves and complete sterility, performed the first radical mastectomy and developed new stomach and intestinal surgeries.
And one more thing: During his entire time at Johns Hopkins, Mr. Halsted injected himself with morphine on a daily basis.
Although Mr. Halsted kept his addiction secret from all but a few of his closest colleagues, it was not uncommon for doctors to prescribe morphine to their heroin-addicted patients in the 19th and early 20th centuries, and the prescription morphine allowed them, like Mr. Halsted, to remain productive members of society.
Heroin-assisted therapy is therefore not a new or radical idea, despite what you might have heard in light of news that doctors in Vancouver began prescribing pharmaceutical-grade heroin (diacetylmorphine) to heroin-addicted patients this week.
The patients were originally subjects of clinical trials investigating the effectiveness of heroin-assisted therapy among chronic heroin addicts who had repeatedly failed at other forms of treatment including methadone maintenance. The trials found that heroin-assisted therapy improved users' physical, mental and social health, resulted in a reduction of criminal behaviour and increased uptake of employment and education programs.
You'd think that would be sufficient reason to continue the therapy after the trials ended, but no. While Health Canada originally approved continued treatment, federal Health Minister Rona Ambrose introduced new regulations last October which prevented prescribing heroin outside of clinical trials. Five heroin users challenged Ms. Ambrose's decision in court, and British Columbia Chief Justice Christopher Hinkson granted an injunction in May, allowing heroin-assisted therapy to proceed.
You might wonder why Ms. Ambrose introduced the regulations, since ending the therapy since would likely adversely affect the heroin users' health and increase the risk of their returning to criminal behaviour. But then again, drug laws have never been about improving health or reducing crime.
Indeed, the first law criminalizing heroin – the Opium Act of 1908 – was introduced by minister of labour Rodolphe Lemieux. Now one would expect the minister of health or the attorney-general to spearhead the law if it concerned health or crime. But it wasn't about health or crime. It was about racism.
In the mid-19th century, many Chinese immigrants made their way to Western Canada and found work building the Canadian Pacific Railway. Although these labourers were prized for their willingness to work long hours for little pay, things changed when Canada experienced a recession in the late 19th and early 20th centuries.
White Canadians and, in particular, trade unions, blamed the Chinese for the shortage of jobs, which resulted in the formation of the Asiatic Exclusion League. The league held emotionally charged rallies, one of which resulted in a riot in Vancouver's Chinatown. Many Chinese businesses were damaged or destroyed, which led the deputy minister of labour – a man by the name of William Lyon Mackenzie King – to conduct an investigation.
King found two opium dens among the damaged businesses. Although these dens were operating legally, and opium use was not seen as a problem, the feds decided that they could get rid of the Chinese and thereby placate white Canadians by outlawing the drug.
So began a century of heroin prohibition, a century in which our collective health and welfare took a backseat to politics and prejudice, a century in which the black market took over the heroin trade, with all its violence, a century in which addicts were forced from the doctor's office to the street, with all its diseases and deaths. Now that was a radical idea, and we've been paying for ever since.