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. - --- MAP posted-by: Jackl