I've been writing for some time here at Rosenblog about Vancouver's state-supported hard drug culture; the government-sponsored safe injection site for heroin addicts in the city's bedraggled Downtown Eastside district, the Mayor's push for a "safe inhalation site" for Vancouver crack addicts, and - in a seemingly counter-intuitive approach - plans for government-sponsored heroin distribution to selected hard-core addicts to supposedly wean them from their deadly habit.

The latter effort is finally ramping up, as The Canadian Institutes of Health (CIHR) reports here.

The Canadian government's health research agency, CIHR, is providing $8.1 million for a two-year experiment called the North American Opiate Medication Initiative, or NAOMI. Recruitment of 157 hard-core addicts - who have failed to kick the habit after past methadone treatment - will begin tomorrow in Vancouver. An equal number will be recruited in both Toronto and Montreal. Each group will be subdivided: half will get pharma-grade smack for 12 months, then transition to methadone or another treatment program; half will start with methadone, and like the first group, try to transition to clean.

The effort is based in part on what Left Coast public health sources in Vancouver like to call harm reduction, but it is far from clear that addiction support is not a more accurate description of what has already been occuring in Vancouver, where the safe injection site has done little to ease the violent, intimidating, and drug-centered culture of the notorious Downtown Eastside District (scroll to second half of this Rosenblog post).

Even Canadian health experts are sharply divided on NAOMI, and The White House thinks it's a horrible idea to have government supply illegal narcotics to addicts.

The outcomes of the NAOMI experiment deserve close, and long-lasting scrutiny, as do the European studies cited by NAOMI backers in the initiative's favor. Only 10 percent of heroin addicts quit after a similar Swiss experiment.

If you want to put a face on why more heroin isn't a good idea for junkies, consider the story of Canada's "Dean of Drug Addicts," Dean Wilson.

The Vancouver Courier (preceding link) profiles the star of the documentary, "Fix: An Addicted City." Wilson was head of the Vancouver Area Network of Drug users (VANDU) until the board asked him to resign for stealing $60 he was given to courier a VANDU report to Ottowa, according VANDU official Ann Livingston, who is also the (single) mother of his two-year-old son.

Said Livingston in The Courier last month, "I wish him well, and hope he stops using dope."

Wilson claims he has his addiction "under control," and that he has been on methadone for a year. He lives off welfare, gets $6 a day for food, and has Hepatitis C.

He says Vancouver's safe injection site is a success because 600 addicts a day shoot up there. He works for no wages as a community liaison for a non-profit that finds jobs for addicts at......"facilities such as the injection site."

As Wilson's sad story and his viewpoints illustrate, the Nanny State is interested in managing addiction, not ending it. What is sadly lacking, to date, in all the controversy over government-enabled heroin usage in Canada, is serious discussion, based on comprehensive social health research, of just what ARE the best ways to get heroin addicts off heroin and keep them off. Similarly, there is too little discussion of methadone treatment. How many patients are able to get off methadone and stay off it, and off heroin, for good? This is one large part of where future coverage of the Canadian debacle needs to go, as the NAOMI experiment unfolds.

It is hard to fathom that the selected NAOMI subjects, who could not kick the heroin habit after successive tries at methadone treatment, will somehow do better with guaranteed heroin for a year, and then methadone. There is an entirely plausible case to be made that the government of Canada has lost its mind.

Posted by Matt Rosenberg at February 9, 2005 01:24 PM

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