From huffingtonpost.ca

In what many consider to be a very progressive move, Health Canada is reported to be near launching a nation-wide trial where drug users get prescribed heroin. Chris Mackie, the medical officer of health in London, ON, just met with Canada's health minister, Dr Jane Philpott, last week. He is quoted by CBC News that:

"There is evidence that injectable heroin works, and that it works better than other opioid maintenance therapy, and it should be more widely prescribed than it is now."

Dr Philpott had said earlier that pharmaceutical heroin is a life saver. Similar trials in both Vancouver and Montreal found that prescribing heroin to addicts results in a decreased use of street drugs, less crime to pay for the illegal drugs and a reduction in HIV and hepatitis from addicts using dirty needles.

In one of my earlier HuffPost Canada blogs, I talked about the experiences of Portugal which was the first country to decriminalize drug use and they now have the lowest overdose deaths in all of Europe.

Sadly, the progressive nature of this move is offset by the very regressive government policy on legitimate opioid use by patients in pain who are prescribed it by their doctors. The McMaster University Guidelines on the use of opioids for non-cancer pain was funded by both the Canadian Institute of Health Research and Health Canada who will also fund the heroin trials.

I've written a number of blogs here on the stupidity of these guidelines as have others like Roy Green on his syndicated talk show. A number of pain specialists have spoken out against these guidelines on his show and been quoted by me. The criticisms deal with the fact that patients who have been prescribed high doses of opioids for years and are doing well, are suddenly finding themselves being cut off by their doctors or their doses severely restricted. Some are now going to street dealers and others are planning suicide if they cannot get the relief they have had for years.

In what looks like an attempt at damage control, McMaster just did a lengthy webinartrying to explain themselves. The editor of the Guidelines is Dr Jason Busse who is described on the guidelines as an associate professor in the Department of Anesthesia. He is not, however, a medical doctor but a chiropractor which is how he is described in the webinar.

Chiropractors cannot prescribe any medication and, frankly, I would have been far more comfortable if an actual MD who treats chronic pain patients chaired the group and it was composed mostly of those experts. This was a bit like having a naturopath chair a guideline committee for best practices in cancer care.

He does admit in the webinar that they are now starting to hear anecdotal stories that aggressive reductions are being forced on patients by their over zealous doctors and there is the potential to cause more harm as a result. He ended his talk by saying that there is a real danger of reducing opioids for those who are getting relief and that they do not want to put patients in a worse position when the drugs they take are giving them important relief. 

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