The Vancouver Experiment

Does It Work?

By Matthew Power

One study of Vancouver's injection-drug users has taken harm reduction to a level even beyond Insite. In 2003, the same year that the supervised-injection site opened its doors, an epidemiologist named Martin Schecter began planning a trial that had never been conducted in North America: heroin maintenance. Would a daily course of heroin, administered in a clinical setting, release users from the destructive aspects of maintaining their addiction? Would it benefit society and allow users to stabilize their lives? Similar studies had been conducted in Europe with positive results. Switzerland alone has 38 heroin maintenance centers, and they are a fully integrated part of its national health system; Germany followed suit last year. Schecter, who has worked in Vancouver since the first signs of the AIDS epidemic in 1983, wanted to see whether such a program would make a difference in Canada.

For the neighborhood's recovering addicts, the ability to escape the daily demands of supporting an addiction is often achieved with a dose of methadone. Methadone's relative benefits are well established: It is slow-acting. It greatly reduces cravings for heroin and blocks heroin's euphoric effects. When successful, methadone maintenance can give addicts their lives back. But there are high rates of relapse among long-term addicts.

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