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Handing Out Heroin

Would we all be better off if we gave heroin addicts their drugs for free?

A groundbreaking experiment in Canada suggests the answer is a qualified "yes."

From early 2005 to mid-2008, 251 hardcore junkies in Vancouver and Montreal were given taxpayer-funded opiates as part of an experimental program run by local health officials. Dubbed the North American Opiate Medication Initiative, the $8 million program was one of the most radical examples of Canada's embrace of the "harm reduction" school of thought toward illegal drug use. The idea is basically to treat substance abuse as primarily a health issue, not a criminal justice issue. Vancouver has taken this approach further than any other city in North America; Miller-McCune took an in-depth look at how it's working in the November issue, which you can find here.

The study's participants had all been addicted for at least five years and had failed to kick the habit through treatment at least twice. They were split into three groups: one was given oral methadone, a second received pure heroin and a smaller third group got injection hydromorphone, aka Dilaudid, a prescription opiate.

Preliminary results released in early October indicate that the legal daily doses did indeed reduce drug-related harm — although they didn't eliminate it. Twelve percent of those given heroin and nearly half of those given methadone dropped out of the program. But those who stayed in reduced their illegal heroin use by almost 70 percent. And the proportion who committed crimes dropped from 70 to 36 percent. Their health improved as well. NAOMI researchers say these findings echo those of similar studies in Switzerland, Germany, Spain and the Netherlands.

The NAOMI results have to be taken with a soupçon of salt, though, since they are mainly based on self-reporting by study participants. Critics charge the addicts might have overstated their results in hopes of keeping the program going.

One finding that surprised the researchers was that the small subset addicts who were given Dilaudid — under double-blind conditions — did just as well as those given heroin. That's significant for the future of such efforts, because getting official permission — let alone public support — to buy and distribute heroin is extremely tough. Dilaudid, a legal drug, is a much easier sell. With the promising results they've racked up thus far, the NAOMI researchers are hoping the government will give them and the addicts they study another shot.