Pubdate: Mon, 05 Mar 2007
Source: Globe and Mail (Canada)
Copyright: 2007, The Globe and Mail Company
Contact:  http://www.globeandmail.ca/
Details: http://www.mapinc.org/media/168
Author: Camille Bains, Canadian Press
Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction)

DRUG PROJECT HAS FLAWS, B.C. DOCTORS' GROUP WARNS

VANCOUVER -- Doctors who participate in a proposed project aimed at 
fighting drug addiction among cocaine and crystal-meth users may not 
be equipped to help the vulnerable population, says a spokesman for 
the B.C. College of Physicians and Surgeons.

Morris Van Andel, registrar of the college, said Vancouver Mayor Sam 
Sullivan's recent announcement about a research trial to substitute 
prescription drugs for illegal street drugs is more hype than reality.

"Currently, we're talking ideal, we're not talking real," Dr. Van 
Andel said of the Chronic Addiction Substitution Treatment research 
project, or CAST.

Mr. Sullivan has said the project could be launched in the fall. It's 
already being lauded by former drug addicts, and he has said it would 
reduce crime by those looking for money to score drugs.

Dr. Van Andel said that while he hopes the project will benefit 
addicts, the college has concerns.

"We have raised some questions and we continue to have questions, 
which may have suitable answers but which so far have not been answered.

"The suggestion is that the college would say, 'This is wonderful. Go 
for it.' And we are not prepared to say that," Dr. Van Andel said.

"From our point of view, the physicians who are involved in that 
should be knowledgeable. The assumption that every physician can 
prescribe a substitution drug to someone who is significantly 
addicted to crystal meth is a farce."

Unlike Vancouver's safe-injection site, the research trial won't need 
an exemption from Health Canada to proceed because legal prescription 
drugs will be used.

The federal government will still need to approve the clinical trial itself.

David Marsh, an addiction expert with the Vancouver Coastal Health 
Authority, said any doctors who participate in the project will be 
fully qualified.

He said several physicians are already working on various drug trials 
in the city.

They include those involved in NAOMI, the North American Opiate 
Medication Initiative, which offers junkies free, measured doses of heroin.

Dr. Marsh said research protocols for the proposed trial he's 
involved with have not yet been written, and that the B.C. College of 
Physicians and Surgeons will be invited to participate before the 
protocols are completed.

Peter Selby, clinical director of the addictions program at the 
Centre for Addiction and Mental Health, said Canada has a shortage of 
doctors trained to deal with addiction.

"It's not that physicians are falling over themselves to come and get 
trained in this area," he said.

The Toronto-based facility is the only place in the country where 
physicians can learn to deal with the issue through a one-to two-year 
program, he said.

He added that doctors who become certified through the centre 
generally work in formal addiction programs and wouldn't be suited to 
help people in the Vancouver project.

"They never, ever see people, or very rarely see people, who are from 
the Downtown Eastside," Dr. Selby said, referring to the part of 
Vancouver where addicts openly buy, sell and use drugs.

"Just getting certified is not adequate or sufficient for this. This 
is new, this is cutting edge, this is something that they will have 
to define," he said.
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MAP posted-by: Jay Bergstrom