The idea that regulated heroin might have the power to curb fentanyl-driven overdose deaths and fight organized crime was floated from the BC Centre on Substance Use.
Dr. Evan Wood of the BCCSU advocated “urgent” implementation of prescribed heroin using a compassion-club-type model last month.
Some Chilliwack voices are saying it’s an idea worth exploring.
Sherry Mumford has worked in the addiction treatment field for more than 25 years, and was involved in the development of the Riverstone Home and Mobile Detox in Chilliwack for Fraser Health.
“I think that Chilliwack in particular, being a slightly more progressive community, could take a look at what Dr. Evan Wood is suggesting, and consider it seriously,” Mumford said about prescribed heroin.
“Chilliwack is getting some new housing for the homeless and wouldn’t it be nice to also offer a program with supports that doesn’t involve harmful substances?”
Society is already spending considerable taxpayer dollars on curbing opiate addiction, she argued, so why not support something new and innovative?
“I think that Ottawa’s decision to ease restrictions on physicians prescribing methadone so they do not need to request exemptions, as well as the idea of allowing heroin of a pharmaceutical grade to be prescribed, are both excellent ways of saving lives,” Mumford said.
Some say that the answer for people with addictions is to simply get them to enter treatment and stop taking drugs.
“But that is not how treatment works,” Mumford underlined. “You cannot force people to change. People have to want to be in treatment and make changes.”
The lives of addicted people matter, too, she added, and not everyone struggling in that way would benefit from forced treatment.
“I’m not excusing the criminality in any way but being full blown addicted is not a criminal issue. It’s a health issue. So let’s first take a look at them through the health lens of addiction.”
Something similar to the way the Managed Alcohol Program works to save lives might be advantageous, Mumford said, with specific doses meted out at specific times.
“I could see giving them untainted, prescription heroin, and as you do that, have a team offering support, detox, and health services at the same time,” she said. “Naysayers say that it’s enabling, but it’s completely not true for a certain component of the population.”
For some, who’ve tried conventional treatment, either stopping cold turkey, or with the help of 12-step programs, and it has not worked, this option of going the legal, prescription route may offer a way out of the cycles of addiction.
Mayor Ken Popove said he’d be willing to consider it, if it were shown to reduce overdose fatalities. He also has said in the past that he would support supervised consumption sites as well.
“I would be happy to look at any program that reduces harms,” Popove said, about regulated heroin. “If the data supports it and the results look positive, I would support it.”
Griffin Security owner Brian Goldstone said he was interested in the idea of legally prescribed heroin when he heard about it in February. So he asked some people he knows on the streets about it.
“They told me you can’t just replace fentanyl with heroin,” Goldstone said. “They said they can’t go back,”
Maybe the untainted heroin could be used temporarily in some cases, like methadone, to effectively stabilize some of the substance users. It might even mean cutting down on the number of stolen bikes, or entering supportive housing for a portion of the population, he said.
“The problem is the fentanyl is so addictive, that they require the batches to be stronger and stronger, and they are,” Goldstone commented.
Whenever someone in Chilliwack overdoses or dies and word gets around, there’s this strange phenomenon where some of the users want to know exactly which dealer sold it to that person who overdosed because it means that batch was stronger, and therefore delivered a better high.
“They really believe the Narcan is going to save them. But it is taking more and more of it all the time to bring them back,” Goldstone said.
So for some of the heaviest fentanyl users, it might not work if the solution is to switch to pure heroin, but on paper it does look like an idea worth exploring for some.
“From what I can see, the idea is a fine one,” Goldstone continued. “But the guys who are users here say it just won’t work. I don’t understand all the logistics. Maybe they just don’t want to try.”
At this point, the idea is not being implemented anywhere yet. Health Canada would need to approve the model, by providing an exemption either to the Controlled Drugs and Substances Act for research or public health reasons or through another regulation that has allowed B.C. to import injectable pharmaceutical-grade heroin from Switzerland.
In the wake of the idea, B.C.’s provincial health officer and chief coroner both called for the federal government to allow the province to offer access to legal heroin.