Heroin as drug treatment saves lives, millions of dollars: clinic
Emma Jarratt, Brian Mellersh and Jon Woodward, W5
Published Tuesday, April 25, 2017 7:00AM EDT
Every minute of every one of John Pinkley’s days was once consumed with the hustle for heroin.
The 57-year-old addict needed to stave off withdrawal – and over 3 decades of drug addiction that left him working, begging, sometimes stealing for a fix. It left no time for anything else.
“There was a time when I was fixing and I was living in a tent and I wasn’t sure what I really wanted any more. I was tired of everything,” Pinkley said.
But when his friend Joe died of a drug overdose on a stained alley stairway, Pinkley started looking for help.
He found it in an unusual place: a Vancouver clinic that doesn’t try to wean users off drugs. Instead, the Crosstown Clinic provides the heroin for them, legally, for free.
It’s an unfathomable idea in parts of Canada, but in Vancouver, it’s the kind of thinking authorities hope could stop the epidemic of drug overdoses in a province where more than five people a day died in December.
It’s one of the solutions profiled in a new W5 documentary, "48 Hours," that explores the race to save lives in Vancouver, the ground zero of Canada’s opioid crisis.
At the clinic, the goal is to get its 150 patients stabilized, not stoned, said its head physician, Dr. Scott MacDonald.
“This is just a chronic, manageable disease, no different than diabetes or high blood pressure and people need their treatment,” said Dr. MacDonald.
“Many of the deaths in this opioid crisis are unnecessary, and when there’s safe, effective, cost-saving treatments – we waited too long and this needs to be expanded and expanded now,” he said.
Prescription heroin therapies have existed for nearly a century, first in the U.K., then moving to other European nations, including Switzerland, where a catastrophic overdose epidemic nearly crippled the country in the late 1980s and early 1990s.
Results from the Swiss program are astonishing.
By 2004, 10 years after the first prescription opioid clinic opened, the national drug-related death toll had fallen by 50 per cent and business to the illicit heroin market was down 82 per cent.
Today there are 23 substitution therapy clinics servicing roughly 70 per cent of Switzerland’s heroin addicted population.
Canada is a long way off from creating a network of therapy clinics, but that program is gaining traction in Vancouver.
Right now, 91 chronic opioid addicts are given access to a legal, daily prescription heroin program with a further 24 taking a less potent morphine derivative. On average, each Crosstown patient has tried 11 different therapies. This program is their last resort.
MacDonald said it saves the public money.
“When people are using illegal opioids, it’s a public health disaster. The cost of illicit opioids is enormous. We estimate that the cost for one person using illicit opioids is at least $48,000 a year,” he said.
“We can provide this treatment at this clinic for about $25,000 a year and if you build in efficiency you might get that down to $14,000 a year,” he said.
Add it all up, and he said he thinks the clinic has already saved Vancouver millions of dollars.
Doctors estimate there are some 500 more people who could benefit from the treatment, but it hasn’t yet had the money to expand.
In Canada there has never been a successful attempt to stamp out addictive substances.
From banning opium dens in the early 1900s to alcohol prohibition in the 1920s to the 1997 Tobacco Act, each has turned into a game of addiction whack-a-mole that’s marginalized vulnerable populations, created an opportunity for a roaring black market trade and cost society billions of dollars in medical, legal and incarceration expenses.
"I have yet to meet anyone who has stopped using drugs because they have been jailed or criminalized,” said B.C. Centre for Disease Control medical director, Dr. Mark Tyndall, at a recent forum on drug policy in Canada.
Tyndall is an advocate for proactive rather than punitive drug policies.
That includes voicing support for an initiative unfathomable to some: prescription opioid programs for chronically addicted users.
“When I look at my life now I would say, yes, this is my answer,” said Pinkley. He hasn’t had to spend time feeding his habit, which has let him get his life back on track.
“This is keeping me healthy; it’s keeping me out of jail. It’s keeping me focused on a lot of things. I’ve already gone back to school,” he said.
And he thinks it has saved his life.
“I’m thankful […] that I was able to break away from it and to see the human tragedy behind it all and not want to lose myself to it,” he said, remembering his friend who had died. “I know, but for the grace of God go I, that could be me.”