Barriers remain for accessing pharmaceutical-grade heroin

Inside the Vancouver Network of Drug Users' overdoseprevention site,Ryan Kingston injects heroinas a volunteer watches through awindow to make sure nothing goes wrong.

Kingston has overdosed here before.

He has being using heroin for the past year to easehis chronic back pain. He's also on methadone, butsaid his prescription doesn'tnumb the pain caused by the three bulgingdiscs in his spine.

"I'd like to get on something that would work. I just haven't been prescribed anything that does that, so I'm stuck having to use street drugs to accomplish that," he said.

Kingston, like many other opioid drug users, believes he wouldbe better off if hehad access to medical-grade heroin,generally used to treat patients who haven't had success with substitution therapy like suboxone or methadone.

The Federal Health Minister's announcement on Monday brings them hope that access to medical-grade heroin is a step closer to reality.

MinisterGinette Petitpas Taylor announcedregulatory changesthat could see heroin which can currently only be legally administered in a hospital setting prescribed and administered by physicians and nurse practitioners at treatment facilities.

• B.C. doctors welcome Ottawa's move to make it easier to prescribe heroin and methadone

Still heavily regulated

But barriers still remain to accessing medical-grade heroin.

JordanWestfall, president of the Canadian Association of People Who Use Drugs, says the changes won't amount to anything unless medical-grade heroin is more widely available in Canada.

"Heroin is still heavily regulated and it needs to beimported into the country," saidWestfall.

Pharmaceutical-grade heroin (diacetylmorphine) is manufactured in Switzerland and can only be imported to Canada in bulk, at times of public-health emergencies.

"It makes it hard to access. What needs to happen is that this drug should be manufactured in Canada," said Westfall.

In order for it to be manufactured in Canada, a companyneeds to apply for aDrug Identification Number (DIN), which is a lengthy process involving severalgovernment hurdles.

Currently, the only place offering diacetylmorphine in Vancouver isthe Crosstown Clinic in the Downtown Eastside.Only about 100 Canadianshave access to it through the single pilot project. There is a waitlist of 200.

If they wait much longer there won't be anybody who needs to use it because everyone is going to be dead.- Laura Shaver, president of BCAPOM

The regulatory changes come into effect in May, butwhether the supply of diacetylmorphine will change is undetermined.

That's not good enough forLaura Shaver, president of the British Columbia Association for People on Methadone (BCAPOM) and secretary at the Vancouver Network of Drug Users (VANDU).

"If they wait much longer, there won't be anybody who needs to use it because everyone is going to be dead. There won't be any patients to go on heroin prescription," said Shaver.

Death toll to surpass 4,000

Figures released by Health Canada on Tuesday show that a record number of Canadians died of opioid overdoses in 2017.Fatal overdoses were up more than 45 per cent from the year before.

The government expects the final 2017 death toll will surpass 4,000.

B.C. has been hit particularly hard by theopioid crisis. More than 1,420 people died of illicit drug overdoses in B.C. in 2017. Fentanyl caused more than 80 per cent of suspected deaths last year.

Harm reduction activist and methadone userGarthMullinsargues pharmaceutical-grade heroin needs to be far more widely available, beyond treatment facilities and hospital settings.

Research has shown prescribed heroinreduces illicit drug use, criminal activity and mortality.

"Someone should be able to go in to any doctor in B.C. and get on prescription heroin, if they are a suitable candidatefor that. That's what it means to respond to the overdose crisis. That's what it means to have drug treatment" saidMullins.

• Jane Philpott says pharmaceutical heroin a potential lifesaver in opioid epidemic

• Continue reading: CBC interactive piece on 'How Europe's heroin capital solved its overdose crisis'