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Heroin to be prescribed to Canadian addicts by doctors

Following a court battle, doctors at a medical facility in Vancouver will be able to prescribe the drug to patients who have not responded to other treatments

Sunday 23 November 2014 18:11 GMT

Used syringes (Getty)

Doctors in Canada will become the first medics in North America to prescribe heroin to addicts next week.

Staff at the Vancouver-based Providence Crosstown Clinic have received a shipment of medical grade heroin and will begin prescribing the drug over the coming days.

Health Canada has authorised 120 people to receive the prescriptions, 26 of whom were participants in a previous trial which worked with individuals who had not responded to more conventional treatments.

Following the trial doctors wanted to continue to prescribe heroin to patients in their care, but were unable to after Rona Ambrose, the federal health minister, introduced regulations banning heroin prescriptions outside of clinical trials in October 2013.

Medics went to the supreme court of British Columbia and successfully petitioned it to grant an injunction against the ban.

Drug addiction, overdoses, and a very brief history of Heroin

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1/14Drug addiction, overdoses, and a very brief history of Heroin

Drug addiction, overdoses, and a very brief history of Heroin

Heroin – the chemical name for which is diacetylmorphine – was originally synthesized by British chemist C.R.Alder Wright (pictured overleaf) in 1874, by adding two acetyl groups to the molecule morphine, which is naturally found in the opium poppy.

Drug addiction, overdoses, and a very brief history of Heroin

Bayer, the German pharmaceutical company behind Alka-Seltzer and Aspirin, bought the rights to diacetylmorphine, marketing it under the name “Heroin” in 1895 because early testers said that it made them feel “heroisch” or “heroic”.

Drug addiction, overdoses, and a very brief history of Heroin

By 1898, it was ready for mass marketing. It was originally sold as an over-the-counter cough suppressant that didn’t have problematic side effects, like addiction (the irony) - while alternative treatments morphine and codeine did. This was before they realised that, when taken into the body, it actually converts into morphine, and is ferociously addictive. Thus defeating the object and defining what was to become a historically embarrassing moment for the company in later years.

Drug addiction, overdoses, and a very brief history of Heroin

By 1899 Bayer was producing a ton of Heroin and exporting the drug to 23 countries, while free samples sent to doctors and studies appeared in medical journals. It was also around this time that early reports of addiction began to surface. The company wisely released Aspirin this year, which would go on to become one of the most popular and widely used pain relief drugs in the world.

Drug addiction, overdoses, and a very brief history of Heroin

US medicines containing heroin were available over the counter from 1907, after the American Medical Association gave it its stamp of approval.

Drug addiction, overdoses, and a very brief history of Heroin

As Heroin dependency became a torrent and overdoses began to be reported, Heroin was made illegal to obtain without a prescription from a doctor in the US in 1914. Bayer lost some of its trademark rights to Heroin and Aspirin under the Treaty Of Versailles in 1919, after the German defeat in World War I.

Drug addiction, overdoses, and a very brief history of Heroin

In the early 1920s, a number of addicted users in New York supported themselves by collecting and selling scrap metal retrieved from industrial dumps. It was from this that the label “junkies” was born. The behavior of Heroin addicts was soon, however, to cause a concern to the public and the authorities. In 1924, it became completely illegal, and doctors were told they could no longer prescribe the drug.

Drug addiction, overdoses, and a very brief history of Heroin

By this point, Heroin had become popular among creative industries. Pictured left is famed actress Jeanne Eagels, who died of a Heroin overdose in 1929. Its outlawed use had pushed manufacturers underground, and the purity of the product illegal traders now used varied in quality.

Drug addiction, overdoses, and a very brief history of Heroin

In the UK, the Rolleston Committee Report in 1926, illegal Heroin dealers were prosecuted, but doctors could prescribe diacetylmorphine to users when they were withdrawing from it, if it would cause harm or severe distress to the patient to go without it. This would be the law until 1959 when the number of diacetylmorphine addicts doubled every 16 months between 1959 and 1968.

Drug addiction, overdoses, and a very brief history of Heroin

The Brain Committee recommended that only selected, specially approved doctors at specialized centres were allowed to prescribe diacetylmorphine to users in 1964. The law was further restricted in 1968, and by the 1970s, the emphasis shifted to encouraging abstinence and the use of substitute methadone.

Drug addiction, overdoses, and a very brief history of Heroin

In the 1980s, the UK experienced a surge in Heroin supply because of a sudden cheap influx from Pakistan (the main supplier had been – and is now – Afghanistan). Cues from popular culture – and a social downtown caused by the economic and industrial crisis in the late 1970s – created the perfect environment for the Trainspotting generation.

Drug addiction, overdoses, and a very brief history of Heroin

In the 1990s, Heroin use was again popularized by the rise of grunge and Britpop, while the emergence of ‘the waif’ in fashion, of which Kate Moss is often cited as the originator, would give rise to the term ‘Heroin chic’. In 1994, the Swiss began to trial a diamorphine maintenance program for users who had failed multiple withdrawal programs. It aimed to maintain the health of the user, by discouraging the use of illicit street Heroin. It was deemed a success.

Drug addiction, overdoses, and a very brief history of Heroin

Today, the largest producer of opium, needed to create Heroin is Afghanistan. This is closely followed by Mexico, who increased their rate of production sixfold between 2007 and 2011. Diacetylmorphine is a controlled, Class A substance in the UK, but continues to be used in palliative care for the treatment of acute pain, such as in severe physical trauma, post-surgical and chronic pain, as well as relieving sufferers of terminal illnesses.

Drug addiction, overdoses, and a very brief history of Heroin

Key figures continue to campaign for greater sympathies and better treatment of Heroin addicts as they attempt to rehabilitate themselves and re-enter society. Russell Brand’s Give it Up Fund, run in conjunction with Comic Relief, aims to provide financial aid to help people remain free from substance abuse by setting up support groups. "It's integral that people entering a life of abstinence after the chaos of addiction have stability, support and a role to play in the wider community," he said.

David Byres, vice-president of Acute Clinical Programs at Providence Health Care, told the Globe and Mail: "The patients are so desperate for treatment, so desperate to be able to no longer be addicted.

"It’s a great thing to be able to help them, and help with the addiction that has taken over their entire lives."

Patients who are prescribed the drug must attend the clinic at least three times a day, at set times, and let nurses monitor them for adverse effects.

Since banning the use of prescription heroin, outside of trials, in October last year around 30 people have left doctors’ care at the Providence Clinic and some are believed to have relapsed and are now taking illegal heroin.

The federal Conservative government has maintained that it is opposed to doctors prescribing heroin to drug users.

In the UK prescription heroin is already legal and has been widely used across the country for a number of years as a treatment for heroin addicts.

Other European countries, including Germany, the Netherlands and Switzerland, also allow heroin based treatments for those who do not respond to more traditional therapies.

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