Pubdate: Mon, 16 Sep 2002
Source: Globe and Mail (Canada)
Page: A5
Copyright: 2002, The Globe and Mail Company
Contact:  http://www.globeandmail.ca/
Details: http://www.mapinc.org/media/168
Author: Robert Matas
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/find?131 (Heroin Maintenance)

HEROIN STUDY VIOLATES ETHICS, ACADEMIC SAYS

VANCOUVER -- A controversial proposal to offer free heroin to addicts in 
Montreal, Toronto and Vancouver for research purposes violates ethical 
norms, Canadian bioethicist Louis Charland says.

"How can an individual who is addicted to heroin voluntarily consent to 
participate in research where their drug of choice is offered free of 
charge?" Prof. Charland stated in a recently published article in the 
American Journal of Bioethics.

"When I put these questions to Cynthia, a recovering heroin addict at a 
local clinic, her reaction was disbelief and amazement. 'That's crazy,' she 
said. 'If you're addicted to heroin, then . . . you can't say no to the 
stuff.' "

Prof. Charland, who teaches in philosophy and health-science departments at 
the University of Western Ontario, said heroin addicts with a compulsive 
need to use the drug cannot satisfy a research standard of competent and 
informed voluntary consent.

"Ethical and clinical discussions of heroin prescription seem to have 
missed this point entirely," he said in the journal, based at the 
University of Pennsylvania Center of Bioethics.

A group of Canadian researchers are currently putting together a proposal 
for a national project to evaluate whether free heroin for addicts will cut 
crime, control health costs and help the drug users deal with their addiction.

The first meeting of an advisory group for the research project is to be 
held next month. A formal application for federal funding will likely be 
considered this winter. The proposal also requires the approval of an 
ethical review committee.

The proposal is that addicts in the study receive heroin under medical 
supervision for a year. A control group would be offered methadone, a drug 
that eliminates an addict's desire for heroin without providing the high.

A similar research project in Switzerland in the 1990s found that 
prescription heroin led to a decrease in the use of all types of illicit 
drugs, reduced criminal behaviour and improved health. Swiss researchers 
concluded that heroin prescription was both feasible and clinically effective.

However, the Swiss research "would appear to violate existing North 
American ethical standards for clinical research," Prof. Charland stated.

In an interview, Prof. Charland said he was undecided about whether 
research on heroin prescriptions should go ahead.
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