Background materials and press release concerning heroin
prescription motion introduced by Libby Davies, MP
BACKGROUNDER: M-454 April 14, 1999
Libby Davies, MP
Re: Motion to implement clinical, multi-centre heroin prescription
This briefing note is meant to provide you with some information
background concerning my private member’s motion, M-454.
M-454: That, in the opinion of this House, the government in
operation with the provinces, implement clinical, multi-centre
prescription trials for injection opiate users, including protocols
rigorous scientific assessment and evaluation.
Background and Intent
This motion is about providing sane and regimented TREATMENT
OPTIONS for health
care professionals and the IV drug users under their care.
In supporting it, we are calling
on parliamentarians to take a serious look at the drug crisis
in our country with the
ultimate goal of:
Reducing the harm associated with obtaining
drugs on the street.
Protecting the community.
M-454, and the clinical, multi-centre heroin prescription
trials it supports, fits
within the broader framework of a harm reduction approach to
Harm reduction is defined in the 1997 Taskforce Report,
“HIV, AIDS and Injection
Drug Use: A National Action Plan”, this way:
“While neither condoning nor condemning drug
use, the harm reduction model
accepts that drug use continues to occur, and that
many initiatives can be undertaken
to minimize the harmful outcomes of drug use to
“The Task Force, in accessing the issues around
HIV, AIDS and IDU, recognizes
that abstinence is not always a realistic or feasible
short-term goal for the individual
using illegal drugs and that, in the interest of
public health, alternative methods must
M-454 simply states that a medical approach to heroin
maintenance is one alternative
that should be explored. M-454 is not about the
“legalization of heroin”.
M-454 does not condone heroin use.
The aim of this motion is to facilitate the research needed
to implement an effective,
alternative, regulated treatment option for heroin addicts.
The Grim Facts: This is a National Emergency
In my riding of Vancouver-East, a health emergency has
been declared as a result
of an epidemic of HIV infection among injection drug users.
In British Columbia the death toll is staggering.
As of November of last year, a
record 371 people died of overdose deaths in 1998 alone, 195
in the Vancouver area.
Overdose from Intravenous Drug Use has become the leading
cause of death for
adults age 30-49 in the province of British Columbia.
Over and above that, the leading
cause of HIV infection is now IDU.
It’s estimated that there are 15,000 regular, frequent
injection drug users in the
province of British Columbia alone. It is estimated that
one-quarter of injection drug
users are HIV-positive, and that most (88%) have hepatitis C.
HIV-infected drug users are showing up in larger numbers
in the Kamloops and
Kootenay regions and the threat of more and more British Columbians
continues to intensify.
This is not only a health emergency for the residents
of BC. It is a growing
emergency in centres across the country, particularly urban
centres, where the incidence
of drug use is on the rise. Other communities across Canada
are also facing serious issues
around drug addiction and the medical and social emergency that
stems from it. Clearly,
this is a national health emergency being played out in the
streets of Toronto, Montreal,
Winnipeg and dozens of other cities across the country.
Medical Solutions Benefit the Entire Community
A criminal approach alone to drug addiction just doesn’t
make economic sense.
Despite stepped-up police enforcement, illicit drug use now
costs the BC economy an
estimated $209 million each year – and the figure is climbing.
In comparison, research shows that drug treatment programs
are capable of
reducing crimes by 80%. Research shows that for
every dollar we spend on drug
treatment services, seven dollars can be saved in medical, social,
The European Experience:
We can benefit and learn a great deal from demonstrated,
successful programs in
Germany, England, the Netherlands and Switzerland. Swiss
Trials, in particular, prove
the benefits of heroin maintenance.
Swiss Trials: When the Swiss government implemented nation-wide
prescription trials in 1994 the evidence overwhelmingly supported
the social benefits of
heroin maintenance. Some 1000 volunteers – only heroin
addicts with at least two
unsuccessful experiences in methadone or other conventional
treatment programs were
considered – took part in the experiment.
The results so far: criminal offences and the number of
criminal offenders dropped
60 percent, the percentage of income from illegal and semi-legal
activities fell from 69 to
10 percent; illegal heroin and cocaine use declined dramatically;
increased from 14-32 percent; physical health improved enormously,
participants greatly reduced their contact with the drug scene.
There were no deaths from overdoses, and no prescribed
drugs were diverted to
the black market. A cost-benefit analysis of the program
found a net economic benefit of
$30 per patient per day, mostly because of reduced criminal
justice and health care costs.
Support for a harm reduction model is growing.
On the parliamentary front, I recently invited MPs and
Senators to participate in a
working group to open up the debate and support an intelligent
harm reduction approach
to illicit drug use. The response has been encouraging.
Approximately 18 Members of
Parliament and Senators, representing every political party
Support has also been growing for a heroin maintenance
plan, as part of a broader
harm reduction approach to dealing with drug addiction.
Over the last few years, more
and more health experts have come out in support for such an
initiative. These include:
Former BC Provincial Health Officer
John S. Millar in his 1998 report, “HIV,
Hepatitis and Injection Drug Use in British Columbia
- Pay Now or Pay Later”. Millar
legal availability of heroin, in a tightly controlled system of
should be pilot tested as an option, as part of a
A 1997 Health Canada-funded National
Task Force on HIV, AIDS and Injection Drug
Use which included representatives from the Canadian
Association of Chiefs of
Police; the Canadian Bar Association, and the Canadian
AIDS society among others.
The Task Force recommended a continuum of treatment
options and called on the
federal government to:
clinical trials of prescription morphine, heroin and cocaine as
such as are being done in other countries.
High-ranking Health Canada officials,
including Bruce Rowsell, director of the
Bureau of Drug Surveillance in Health Canada’s therapeutic
Products Program. Mr.
Rowsell has said: “… an initiative to gather evidence
looking at the benefits and risks
of heroin maintenance will be helpful.”
The CAIN Task Force chaired by the Chief
Coroner of BC, 1994.
The Canadian Psychiatric Association.
The Canadian Addiction Research Foundation.
A number of international experts including
NY-Based Lindesmith Centre.
Nations around the world – a medicalized
approach to drug use has been effective in
reducing deaths in Zurich, Switzerland and Frankfurt,
(Even the Fraser Institute – a right wing “think tank”-
has agreed that harm-reduction is
the economically viable option in dealing with illicit drug
I hope, I can count on your support of M-454. If you have
any questions, I would be
pleased to discuss the matter further or provide you with additional
FOR IMMEDIATE RELEASE APRIL 28, 1999
LIBBY DAVIES’ MOTION
ON CLINICAL HEROIN TRIALS
TO BE DEBATED IN PARLIAMENT TODAY
OTTAWA - Vancouver East Member of Parliament Libby Davies’ motion to
implement clinical multi-centre prescription heroin trials will be
debated in the
House of Commons today at 5:30 p.m. (2:30 Pacific Time).
“Its crucial that the government, especially Health Minister Allan Rock,
seriously consider this motion,” Ms. Davies said. “Lives hang in the
She said her motion (M-454) is about providing sane and regimented
treatment options for health care professionals and the intravenous
users under their care, with the ultimate goals of reducing the harm
associated with obtaining drugs on the street, protecting the community
In British Columbia, 371 people died of overdose deaths in 1998, 178
Vancouver area alone. Overdose from intravenous drug use (IDU)
become the leading cause of death for adults age 30 to 49 in the province.
is estimated that the leading cause of HIV infection is now IDU.
“How much more evidence does the government need before it takes action
to curb this crisis?” Ms. Davies asked. “Today’s debate provides
opportunity for an open, meaningful dialogue on harm reduction and
need for a sane approach to drug policy in this country.”
The New Democrat MP said: “Like recent calls to medicalize marijuana
the Canadian police chiefs’ call to de-criminalize possession of small
quantities of illegal narcotics, my motion emphasizes the need for
treatment, education and safety over incarceration.”
“Its time for the federal government to get in step with the professionals
health care, addictions and justice communities, and adopt harm reduction
as a way to dealing with the drugs crisis in this country,” Ms. Davies
“Putting in place the clinical multi-centre heroin prescription trials
called for by
this motion would be an important step in that direction.”
For more information, please call (613) 992-6030