BACKGROUNDER:  M-454    April 14, 1999
 
  Libby Davies, MP
 
  Re: Motion to implement clinical, multi-centre heroin prescription
  trials.
 
  This briefing note is meant to provide you with some information and
  background concerning my private member’s motion, M-454.
 
  M-454: That, in the opinion of this House, the government in co-
  operation with the provinces, implement clinical, multi-centre heroin
  prescription trials for injection opiate users, including protocols for
  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.
      Saving lives.
 
   M-454, and the clinical, multi-centre heroin prescription trials it supports, fits
  within the broader framework of a harm reduction approach to drug addiction.
 
   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 all involved.”
 
     “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
    be considered.”
 
   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 being infected
  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, and criminal
  enforcement costs.
 
   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 heroin
  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; stable employment
  increased from 14-32 percent; physical health improved enormously, and most
  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.
 
   Broad-based Support
 
   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 have responded.
 
   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
    recommended:
           Controlled legal availability of heroin, in a tightly controlled system of
         medical prescription, should be pilot tested as an option, as part of a
         comprehensive harm reduction program.
 
      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:
           Conduct clinical trials of prescription morphine, heroin and cocaine as
         alternative approaches 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, Germany.
 
  (Even the Fraser Institute – a right wing “think tank”-  has agreed that harm-reduction is
  the economically viable option in dealing with illicit drug addiction.)
 
  Conclusion
 
  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 information.
 

         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 balance.”

She said her motion (M-454) is about providing sane and regimented
treatment options for health care professionals and the intravenous drug
users under their care, with the ultimate goals of reducing the harm
associated with obtaining drugs on the street, protecting the community and
saving lives.

In British Columbia, 371 people died of overdose deaths in 1998, 178 in the
Vancouver area alone.  Overdose from intravenous drug use (IDU) has
become the leading cause of death for adults age 30 to 49 in the province.  It
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 an
opportunity for an open, meaningful dialogue on harm reduction and on the
need for a sane approach to drug policy in this country.”

The New Democrat MP said:  “Like recent calls to medicalize marijuana or
the Canadian police chiefs’ call to de-criminalize possession of small
quantities of illegal narcotics, my motion emphasizes the need for health,
treatment, education and safety over incarceration.”
 
“Its time for the federal government to get in step with the professionals in the
health care, addictions and justice communities, and adopt harm reduction
as a way to dealing with the drugs crisis in this country,” Ms. Davies said.
“Putting in place the clinical multi-centre heroin prescription trials called for by
this motion would be an important step in that direction.”
 
                              -30-
 
For more information, please call (613) 992-6030