Five people severely addicted to heroin are launching a constitutional challenge to the federal government's ban on the prescription version of the drug, The Globe and Mail has learned.
Providence Health Care, a Vancouver care provider, is also participating in the case. It is expected to announce the challenge at a news conference with the Pivot Legal Society, which is representing the addicts, on Wednesday morning.
Update: The announcement has been made. Read more: Legal challenge to heroin prescription ban will draw on Insite case
Senior representatives of both organizations will accompany addictions physicians, researchers and some of the addicts, according to a news release issued on Tuesday.
Health Canada's special access program (SAP) had recently approved applications from B.C. doctors to give diacetylmorphine (heroin) treatment to about 20 patients who were completing their participation in a Vancouver-based clinical trial – the first time it had ever done so.
But federal Health Minister Rona Ambrose immediately denounced her own department's approvals, saying they flew in the face of the Harper government's anti-drug policy, and swiftly changed federal regulations to ensure prescription heroin was never again allowed outside of clinical trials.
"The Prime Minister and I do not believe we are serving the interests of those who are addicted to drugs, or those who need our help, by giving them the very drugs they are addicted to," she said at a news conference in Toronto last month.
The challenge is expected to be similar to the one launched in the case of Vancouver's supervised injection clinic, Insite, after Tony Clement, the health minister at the time, refused to renew its exemption to Section 56 of the Controlled Drugs and Substances Act.
In 2011, the Supreme Court of Canada ordered the Harper government to stop interfering with the clinic, saying the government's concerns regarding use of illicit drugs were "grossly disproportionate" to the benefits for addicts and the community. Closing Insite would violate users' Section 7 Charter rights to life, liberty and security, the court said.
The ruling was hailed as a strong affirmation of scientific evidence over political ideology, with experts saying it could affect future cases.
B.C. doctors had renewed calls for access to prescription heroin for participants who had completed their time in SALOME, an ongoing clinical trial led by researchers from Providence Health Care and the University of British Columbia to determine whether hydromorphone – a powerful but legal painkiller – is as effective in treating severe heroin addiction as prescription heroin.
A previous study (NAOMI) by the same researchers, published in the New England Journal of Medicine, had concluded prescription heroin is a safe and effective treatment for the limited group that did not benefit from conventional treatments such as methadone. Participants on prescription heroin were more likely to stay in treatment, reduce consumption of illegal drugs and avoid illegal activities, researchers found.
In both trials, doctors planning participants' exit strategies faced a problem: After the trials, they could either prescribe methadone – which participants had failed at an average of 11 times each – or hydromorphone, a promising drug the safety and effectiveness of which for treating heroin addiction will not be known until late 2014. For this reason, they submitted the SAP requests.
Before approving the applications, Health Canada sought the advice of an independent addictions expert, who described it as "a promising treatment of last resort."
The treatment, which consists of administering pharmaceutical-grade heroin in a medical setting, two or three times a day, is supported by clinical trials worldwide. Switzerland became the first country to offer supervised, injectable heroin treatment in 1994; Denmark, Germany, the Netherlands and Britain followed suit.
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