Pubdate: Fri, 30 May 2014
Source: Globe and Mail (Canada)
Copyright: 2014 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Andrea Woo
Page: S1

COURT RULES TO ALLOW PATIENTS TO CONTINUE SUPERVISED HEROIN USE

Entrenched addicts who were prescribed heroin as part of a B.C.-based
clinical trial will be able to continue receiving the drug while a
larger constitutional challenge is before the courts.

B.C. Supreme Court Chief Justice Christopher Hinkson released his
decision on Thursday, finding risks associated with severe heroin
addiction "will be reduced if [the addicts] receive injectable
diacetylmorphine (heroin) treatment from Providence
physicians."

This is the second time since March that the courts have sided with
doctors and patients over the Conservative government with respect to
controversial medical treatments.

David Byres, vice-president of Acute Clinical Programs at Providence
Health Care, said staff and doctors are relieved by the decision, as
the addicts in question have not been well since the government banned
the treatment. Some have relapsed into illicit heroin use on Vancouver
streets.

"On behalf of our organization, which has had more than a 100 year
history of compassion, and social justice, and working with some of
the most vulnerable and marginalized patient populations, we are
extremely pleased and relieved [by] today's decision," he said.

"It's going to allow our staff and physicians to be able to offer the
most effective evidence based treatment for the patients that we are
working with."

Researchers from Providence and the University of British Columbia
have led two heroin studies in Vancouver, finding that for the small
subsection of severe heroin addicts who do not respond to repeated
attempts at conventional treatments such as methadone, prescription
heroin is an effective second-line treatment.

Those who received prescription heroin in a supervised medical setting
improved in health, reduced criminal activity, maintained ongoing
involvement with the health-care system and fared better overall than
those who remained on methadone, the researchers said.

As participants cycled out of the latest study, doctors applied to
Health Canada to continue prescribing heroin to select addicts outside
the trial setting. In September, Health Canada approved 21 of those
applications - but federal Health Minister Rona Ambrose viewed her
department's decision as a mistake and swiftly introduced new
regulations to make prescribing the drug illegal.

Providence and five of the addicts, represented by the Pivot Legal
Society, launched a constitutional challenge and sought the injunction
while the case was before the courts. The injunction will exempt from
the new regulations all outstanding plaintiff requests and future
requests from study participants "insofar as they are for patients who
are refractory to other treatments and whose physicians have made or
make" an application to Health Canada. There are 202 participants in
the latest trial; each must receive Health Canada approval to continue
receiving the drug.

During the three-day injunction hearing in March, Joseph Arvay, the
lawyer for Providence, argued that the new regulations violated the
Charter rights of the plaintiffs. Specifically, he invoked Section 7
(the right to life, liberty and security of the person) and Section 15
(the right to equal protection and equal benefit of the law without
discrimination).

Lorne Lechance, the lawyer for the federal government, said the
plaintiffs did not prove to the court that they had tried, and failed,
at conventional treatments, suggesting they received suboptimal
methadone treatment while in the heroin study.

Thursday's decision mirrors one recently issued by the Federal Court
in the battle over medical marijuana. On April 1, new regulations took
effect transferring the governing of access to physicians from Health
Canada, and restricting production to select commercial growers. On
March 21, Federal Court Judge Michael Manson granted an injunction,
allowing patients currently licensed to grow their own marijuana to
continue doing so while the legal challenge is before the courts.
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MAP posted-by: Matt