Canadian Gov Reneges on Funding for 2nd Phase Heroin Trials (SALOME)

I had just finshed writing about the success of the latest study by the North American Opiate Medication Initiative (NAOMI) when I stumbled on a news article titled, “Rehab centre upset after Quebec pulls funds for heroin study”. Slightly confused, I quickly read the article and discovered that the fucked up Harper government in Canada were again playing god with people’s lives and putting their ideology before science. Just days after the New England Journal of Medicine published the positive results for Canada’s latest heroin trial, the Harper Government has pulled funding for the second phase of the study called SALOME.

What is the NAOMI clinical trial? (Phase 1)
The North American Opiate Medication Initiative (NAOMI) was a randomized trial aimed at testing whether medically prescribed diacetylmorphine, the active ingredient in heroin, was more efficient than methadone therapy for individuals with chronic opioid dependence who were not benefiting from other conventional treatments. The results show that patients treated with injectable diacetylmorphine were more likely to stay in treatment and more likely to reduce their use of illegal drugs and other illegal activities than patients treated with oral methadone.
-SALOME Clinical Trial Questions and Answers

What is the SALOME clinical trial? (Phase 2)
The Study to Assess Longer-term Opioid Medication Effectiveness is a clinical trial that will test whether diacetylmorphine, the active ingredient of heroin, is as good as hydromorphone (Dilaudid®), a licensed medication, in benefiting people suffering from chronic opioid addiction who are not benefiting sufficiently from other treatments. Also, this study will test if those effectively treated with these 2 injectable medications can be successfully switched and retained to the oral formulations of the medications.
-SALOME Clinical Trial Questions and Answers

It has always surprised me that the conservative Canadian government actually agreed to fund this study but to pull out as soon as the first study produced such positive results raises my suspicions. Were they expecting the trial of heroin assisted treatment (HAT) to fail? Was the promise to fund the 2nd phase just empty rhetoric with the expectations that they would never have to fund part two of a failed study? Considering that the government has just recently introduced new harsher laws for small time drug users including mandatory sentencing and the success of the latest heroin trials, how can we not be suspicious of the Harper Government’s motives.

Rehab Centre Upset After Quebec Pulls Funds For Heroin Study
The Gazette
By Aaron Derfel
August 2009

A Montreal drug-treatment centre is accusing the provincial government of playing politics in killing funding for a three-year study to treat heroin addiction.

The cancellation of the $600,000 grant follows the publication this week of a study showing that giving heroin to hard-core addicts at the centre's supervised clinic leads to higher rates of recovery.

"We're very surprised because all the discussions that we had with the (Social Services) minister in the last few weeks were very positive," said Eric Fabrès, the centre's co-ordinator of quality services. "We can't understand why the minister has changed her position. ... But we find it very peculiar that at the moment that we published the results in the New England Journal of Medicine, the minister decided to withdraw her support from the project."

The study, titled the North American Opiate Medication Initiative (NAOMI), sought to analyze whether heroin-assisted therapy offers more benefit to addicts who want to kick their habit than standard methadone treatment.

The researchers monitored 251 addicts in Montreal and Vancouver. In Montreal, addicts were given heroin at the Centre de recherche et d'aide pour narcomanes.

The study found that among addicts who received heroin by injection, 88 per cent completed the recovery program, compared with a 54-per-cent completion rate for those who took oral methadone.

But researchers also discovered that 10 per cent of addicts who took Dilaudid, a legal prescription opiate known as hydromorphone, did as well as those on heroin.

For the second phase of the research, titled SALOME (Study to

Assess Longer-term Opioid Medication Effectiveness), scientists wanted to compare heroin and Dilaudid for a three-year period.

The rationale is that if Dilaudid is truly as good as heroin in helping diehard addicts recover, it would solve the legal problem of having to use heroin, Fabrès said.

"But without the funding, the project is dead," he added.

Geneviève Trudel, political attaché to Social Services Minister Lise Thériault, said the decision to cancel the grant was simply cost-cutting.

Related Articles:
Canada Provides the Final Proof Needed for Heroin Assisted Treatment
Quebec's landmark heroin study in jeopardy
SALOME: Clinical Trial Questions and Answers

Canada Provides the Final Proof Needed for Heroin Assisted Treatment

Once again, a trial of prescription heroin for long term addicts has proven to be superior to other treatments including Methadone Maintenance Treatment(MMT), buprenorphine and abstinence programs. The results of the study from the North American Opiate Medication Initiative (NAOMI) in Canada has been eagerly awaited as the final proof that heroin assisted treatment (HAT) is indeed a viable and effective solution. Of course, it’s just conversation unless more countries implement it as part of their drug treatment policy & health plans. I especially want the Australian government to look at the evidence and continue on from where the ACT trials abruptly ended. There’s no John Howard anymore to veto an almost unanimous decision and no Major Brian Watters to misrepresent the ANCD. More importantly, there is now more evidence than ever before and a almost universal acceptance that HAT is the most effective treatment for long term heroin addiction.

Study Backs Heroin to Treat Addiction New York Times By Benedict Carey August 2009 The safest and most effective treatment for hard-core heroin addicts who fail to control their habit using methadone or other treatments may be their drug of choice, in prescription form, researchers are reporting after the first rigorous test of the approach performed in North America. For years, European countries like Switzerland and the Netherlands have allowed doctors to provide some addicts with prescription heroin as an alternative to buying drugs on the street. The treatment is safe and keeps addicts out of trouble, studies have found, but it is controversial — not only because the drug is illegal but also because policy makers worry that treating with heroin may exacerbate the habit. The study, appearing in the current issue of the New England Journal of Medicine, may put some of those concerns to rest. “It showed that heroin works better than methadone in this population of users, and patients will be more willing to take it,” said Dr. Joshua Boverman, a psychiatrist at Oregon Health and Science University in Portland. Perhaps the biggest weakness of methadone treatment, Dr. Boverman said, is that “many patients don’t want to take it; they just don’t like it.” In the study, researchers in Canada enrolled 226 addicts with longstanding habits who had failed to improve using other methods, including methadone maintenance therapy. Doctors consider methadone, a chemical cousin to heroin that prevents withdrawal but does not induce the same high, to be the best treatment for narcotic addiction. A newer drug, buprenorphine, is also effective. The Canadian researchers randomly assigned about half of the addicts to receive methadone and the other half to receive daily injections of diacetylmorphine, the active ingredient in heroin. After a year, 88 percent of those receiving the heroin compound were still in the study, and two-thirds of them had significantly curtailed their illicit activities, including the use of street drugs. In the methadone group, 54 percent were still in the study and 48 percent had curbed illicit activities. “The main finding is that, for this group that is generally written off, both methadone and prescription heroin can provide real benefits,” said the senior author, Martin T. Schechter, a professor in the School of Population and Public Health at the University of British Columbia. Those taking the heroin injections did suffer more side effects; there were 10 overdoses and six seizures. But Dr. Schechter said there was no evidence of abuse. The average dosage the subjects took was 450 milligrams, well below the 1,000-milligram maximum level. About 663,000 Americans are regular users of heroin, according to government estimates. The researchers said 15 percent to 25 percent of them were heavy users and could benefit from prescription heroin. That is, if they ever were to get the chance. Heroin is an illegal, Schedule 1 substance, meaning it has a high potential for abuse and serves no legitimate medical purpose. That designation is unlikely to change soon, researchers suspect. In an editorial with the article, Virginia Berridge of the London School of Hygiene and Tropical Medicine concluded, “The rise and fall of methods of treatment in this controversial area owe their rationale to evidence, but they also often owe more to the politics of the situation.”

Canada’s Push for Mandatory Sentencing of Drug Crimes

One country that appears to be progressing with rational drug laws is Canada. They have a safe injection clinic like our Medically Supervised Injecting Centre (MSIC). They have just finished a heroin trial and they are often pushing more sensible cannabis laws. But all is not what it seems. Many of these initiatives that appeared under the previous government are aggressively being challenged by the current conservative, Harper administration

Under Canada's proposed new drug laws, an 18-year-old who shares a joint with a 17-year-old friend could end up in jail. Small-time addicts, who are convicted of pushing drugs near schools, parks, malls or any other prospective youth hangouts, would be automatically imprisoned for two years. And growers caught selling even one plant to a friend would also be incarcerated. -Plan For Minimum, Mandatory Drug Sentences Draws Fire - Canwest News Service

Especially disturbing, is a major bill(C-15) reintroduced to parliament by the ruling government that wants to set mandatory minimum sentences for drug crimes. The original bill(C-26) was introduced in 2007 but was dropped prior to the election. This bill effectively removes a judges ability to set an appropriate sentence when faced with extenuating circumstances. As pointed out by several experts, some countries, especially the US, are moving away from mandatory sentencing because it has not proven to be effective in cutting crime. In fact, mandatory sentencing has previously been deemed ineffective by 2 reports commissioned by the government's own Justice Department. This is a worrying trend where governments are commissioning reports then ignoring them if they conflict with their current policies or ideology. There has been much public scrutiny of the proposed mandatory minimum sentences but the government refuses to acknowledge that there is no evidence that the changes will work. In a public hearing, Justice Minister Rob Nicholson continually dodged the question about evidence and in typical form, waffled on until his time was up. This is an old tactic frequently used by conservative politicians who are faced more and more with science and research that rejects their often pseudo-Christian, right wing ideology - Don’t answer the question being asked, answer the question you wished they had asked. Reality, facts and research are a real killjoy sometimes.

Overall Concerns: There is no proof that mandatory minimums are effective and appropriate measures to reduce drug use and crimes related to drugs. Most evidence shows the opposite. C-26 does not address the core issue of why people use drugs. C-26 increases already imbalanced and over-funded enforcement approach to drug use in Canada without reducing crime rates or drug use. Abandons successful measures such as harm reduction and grass roots education programs. Moves toward expensive, failed US style war on drugs that spends tens of billions a year on enforcement and incarceration while crime rates and drug use soar. Leads to greater incarceration rates and greater burden on courts, police, and prisons. The Bill leaves it open for enforcement to go after the low level dealers and marijuana infractions (The selling of one joint or growing one plant could constitute trafficking) . Current waiting lists for drug treatment beds is from months to years, depending on the city and region, Drug Treatment Courts will only serve to put more people on a waiting list. source: Cannabis Facts

Mandatory minimum prison sentences do not work. In this case, it will just fill the prison system with mostly harmless, non violent citizens. The whole idea of enforcing a set term of imprisonment defeats the purpose of going to court and being sentenced appropriately. This type of sentencing is always aimed at the worst type of offender which is usually in the minority and as a result, nets in many people who do not deserve prison. It’s the role of judges to determine sentences, not politicians and this sets a dangerous precedent for the legal system to become a political tool. The lessons from the US should be a stark reminder that mandatory minimum prison sentencing for drug crimes is purely right wing ideology which has been allowed to interfere with a nations legal system.

Plan For Minimum, Mandatory Drug Sentences Draws Fire By Janice Tibbetts Canwest News Service May 2009 OTTAWA — Under Canada's proposed new drug laws, an 18-year-old who shares a joint with a 17-year-old friend could end up in jail. Small-time addicts, who are convicted of pushing drugs near schools, parks, malls or any other prospective youth hangouts, would be automatically imprisoned for two years. And growers caught selling even one plant to a friend would also be incarcerated. The Harper government's bill to impose Canada's first mandatory minimum prison sentences for drug crimes — removing discretion for judges to sentence as they see fit — has come under intense scrutiny in public hearings, which began last week. Several witnesses have warned the House of Commons justice committee the proposed legislation will fill jails with drug addicts rather than drug kingpins, who will continue to thrive while small-time dealers are knocked out of commission. The all-party committee will likely get an earful again Monday when it hears from another half dozen opponents, including Ottawa drug policy analyst Eugene Oscapella. "It's a wonderful gift to organized crime," said Oscapella, a lawyer who teaches at University of Ottawa. "We're going to drive some of the smaller players out of the business and they'll be replaced by people who do not respond to law enforcement initiatives." The Conservative government proposes to automatically jail dealers and growers at a time when several American states, most recently New York, have retreated from mandatory minimum sentences, saying they are a glaring symbol of the failed U.S. war on drugs. "We're going in exactly the opposite direction," said New Democrat Libby Davies, MP for Vancouver East, whose party will vote against the bill. The Bloc Quebecois also opposes the legislation, which was originally introduced in late 2007, but died last September when the federal election was called. The bill would pass in the minority Parliament if the official Opposition Liberals decide to support it — and MP Brian Murphy cautioned that "the jury is still out" for his party. "The aim of the bill is laudable, we have to crack down on organized crime and the cash cow for it seems to be drugs," said Murphy. The Liberals, at this stage, would probably push for amendments to narrow the bill's reach, rather than vote against it, he said. The United States experience in the last 25 years has shown that mandatory minimum sentences have flooded jails, with a disproportionate effect on drug addicts, the poor, the young, blacks and other minorities. The U.S. surpasses every other country by far in incarceration rates and, meanwhile, the drug business has flourished. Justice Minister Rob Nicholson, who appeared at the justice committee to defend his bill, was unable to supply any evidence from other countries that mandatory minimum sentences have made any difference in reducing drug crime. Two studies prepared for the Justice Department, one in 2002 and the other in 2005, say that mandatory minimums do not work. But Nicholson asserted that the proposed legislation is a smart response to a public outcry to crack down on the growing "scourge" of drugs. "I can tell you there is support for this bill from many ordinary Canadians who are quite concerned about drug abuse," said Nicholson, who called for expedited passage of the legislation. Davies has unsuccessfully challenged the government to supply estimates on how many more people would be incarcerated if the law passes, and the anticipated cost for provincial governments, who are responsible for jails housing offenders serving sentences of less than two years. "It's going to clog up the prison system," she warned. Critics also contend the bill is poorly drafted because it is overly broad and unclear. For instance, the proposal to automatically imprison for at least two years anyone caught selling drugs "near a school" or "any other public place usually frequented by persons under the age of 18" could mean virtually anywhere in an urban area, says the Canadian Civil Liberties Association. "Any place other than those where minors are not permitted could fall under that legislation and thus require a two-year minimum sentence be imposed," Graeme Norton, director of the group's public safety project, told the committee. The proposed legislation would impose one-year mandatory jail time for marijuana dealing, when it is linked to organized crime or a weapon is involved. The sentence would be increased to two years for dealing drugs such as cocaine, heroin or methamphetamine to young people, or pushing drugs near a school or other places frequented by youths. The bill would mean minimum six-month sentences for growing one to 200 marijuana plants to sell, and two years for big-time growers of 500 plants or more. There are already more than two dozen minimum prison terms in the Criminal Code, mainly for murder and offences involving firearms. © Copyright (c) Canwest News Service

Related Articles: Study: Mandatory Minimums Don't Work! - The Rand Corporation Justices Restore Judges’ Control Over Sentencing - New York Times Proposed New Mandatory Sentences For Serious Drug Offences - Schedule Ii Drugs (Cannabis And Marijuana)

Heroin Assisted Treatment in a Pill

Although heroin assisted treatment (HAT) and the many heroin trials have all been very successful, it is still not the perfect solution. Having to visit a clinic 2-3 times a day and the problems associated with injecting are the 2 main obstacles for patients. Some smart cookie in Canada though has come up with a fantastic idea that might go a long way to treating hard core addicts without these obstacles. Heroin in a pill.

The idea of providing morphine, heroin or hydromorphone to hard core addicts is not new and when put into practice has had great success. Sadly though, through blind ignorance, selling the proposal that drug addicts are given addictive drugs legally to inject has not been easy with the media often whipping up a storm of drug hysteria and governments scared of a public backlash. Supplying the drugs via a pill may be the answer. Fear of take away supplies being diverted to the black market would still be a major concern for many so there would need to be a strict monitoring system in place. It is achievable though with a well thought out system. Diversion though, in the real world becomes less of an issue when this simple question is asked:

Why would patients sell their high quality, legal heroin? ... to buy low quality street heroin?

Methadone may be the default treatment but it certainly has it’s problems. As someone who has been on methadone, buprenorphine and Slow Release Oral Morphine (SROM) to treat my heroin addiction, I can testify to the superiority of a morphine pill. Methadone often leaves the patient ‘flat’ which usually doesn’t happen when given drugs like Morphine. For those who don’t respond to methadone, detox. or rehab, having more options can only be beneficial. Once we start getting serious about treating addiction without the accrued bias from years of misinformation, morphine, heroin or hydromorphone in a pill becomes attractive. With strict guidelines, therapy/counselling and close monitoring, we might finally begin to help those long term users who don’t respond to current treatments and continue to use street drugs.

Can Pill Replace Heroin For Addicts?
CTVBC
Febuary 2009
Video report from CTV British Columbia's Maria Weisgarber


Researchers behind a controversial approach to Vancouver's drug problem are trying to launch a new study.

Hundreds of people took part in the NAOMI project, which stands for North American Opiate Medication Initiative. The project provided drug addicts with heroin, methadone and a pain medication called Dilaudid.

Rob Vincent took part in NAOMI. He says his health improved and he was able to work.

"I didn't have to worry about waking up in the morning and worry about where I'm going to come up with the money to get better now," he said.

Now there's a proposal for a similar study, called SALOME (Study to Assist Longer Term Opiod Medication Effectiveness) which would eventually test whether injectable drugs could be replaced with a pill.

"If you could get some people onto oral medication they could be treated much more simply," said Dr. Martin Schechter, a former NAOMI researcher.

The province has called NAOMI's results promising -- but says it's waiting for peer-reviewed published findings. Meanwhile, research advocates hope Tuesday's budget will include money for an international research treatment centre in BC.

"We have world class leading expertise here in Vancouver today," says Trish Walsh with the Inner Change Foundation. "We're just not giving them the tools to do the job."

The NAOMI project ended up finding pain medication worked just as well as heroin. But Dr. Schechter says when the three year study ended, so did the benefits for many of the participants.

"What we've learned is some of the people...a significant proportion of the people that were doing well subsequently relapsed in the first six months," he said.

Rob Vincent relapsed more than once.

"If you're going to make a project such as that where you're going to get everybody's hopes up...at least make it so it's continuous, and if you are going to have a cut-off date, have some sort of back-up, so that they're not just being thrown out back onto the street," he said.

The new project being proposed is another three year study.

Another Successful Heroin Trial - Canada

Finally, the results are in from the North American Opiate Medication Initiative (NAOMI) enquiry into prescription heroin. Ironically though, it’s a bit of a fizzer. It just told us what has already been proven over and over again ... that prescription heroin is a vastly superior treatment than all other current or proposed programs for heroin addiction.

Canada is just the latest country to produce evidence that prescription heroin is more effective than methadone or abstinence based programs. Switzerland, Germany, The Netherlands and Spain have all had heroin trials and documented their success. The UK is currently finishing off their own trial which is already indicating similar results. Belgium, Israel, Denmark and other countries have announced they will also be conducting their own trials or have indicated their interest in doing so.

All participants reduced their involvement in crime and their spending on drugs, and all participants had health improvements, but those in the injectable heroin or hydromorphone group saw the greatest improvements overall. 
-Jessica Werb. Health Straight Talk

Many countries will now be in that political quagmire that faced Australia back in the late 1990s. Is it worth risking political points and the inevitable attacks from the anti-everything brigade for implementing the safest and most successful treatment program to tackle heroin addiction? Luckily this time around, Australia won’t have John Howard to override the consensus of the states or fellow politicians but the Rudd government is yet to prove itself in providing an evidence based policy. There has been no clear direction yet from the government except the usual political posturing about being tough on drugs. Rudd did claim that he would support evidence based policies but drug policy doesn’t always follow the usual rules. Is this going to be too much of a stretch for a church going conservative? Are the likes of Drug Free Australia (DFA) and the twats from the MSM going to derail another attempt at treating a medical problem based on science and research?

Results show that North America’s first heroin therapy study keeps patients in treatment, improves their health and reduces illegal activity
North American Opiate Medication Initiative (NAOMI Study)


VANCOUVER, BC, October 17, 2008 – Researchers from the North American Opiate Medication Initiative (NAOMI Study) today released final data on the primary outcomes from the three-year randomized controlled clinical trial.

“Our data show remarkable retention rates and significant improvements in illicit heroin use, illegal activity and health for participants receiving injection assisted therapy, as well as those assigned to optimized methadone maintenance,” says Dr. Martin Schechter, NAOMI’s Principal Investigator, Centre for Health Evaluation and Outcome Sciences and Professor and Director, University of British Columbia School of Population and Public Health. “Prior to NAOMI, all of the study participants had not benefited from repeated standard addiction treatments. Society had basically written them off as impossible to treat.”

The data, which was collected from 251 participants at sites in Vancouver and Montreal, demonstrate that a combination of optimized methadone maintenance therapy (MMT) and heroin assisted treatment (HAT) can attract and retain the most difficult-to-reach and the hardest-to-treat individuals who have not been well served by the existing treatment system.

Key findings at the 12-month point of the treatment-phase of the study showed that HAT and MMT achieved high retention rates: 88 per cent and 54 per cent respectively. Illicit heroin use fell by almost 70 per cent. The proportion of participants involved in illegal activity fell by almost half from just over 70 per cent to approximately 36 per cent. Similarly, the number of days of illegal activity and the amount spent on drugs both decreased by almost half. In fact, participants once spending on average $1,500 per month on drugs reported spending between $300-$500 per month by the end of the treatment phase. Marked improvements were also seen in participants’ medical status with scores improving by 27 per cent.

Of particular note amongst the findings, participants receiving hydromorphone (DilaudidTM) instead of heroin on a double-blind basis (neither they nor the researchers knew) did not distinguish this drug from heroin. Moreover, hydromorphone – an opiate licensed for the relief of pain - appeared to be equally effective as heroin, although the study was not designed to test this conclusively. According to the NAOMI Study Investigators, further research could help to confirm these observations, allowing hydromorphone assisted therapy to be made more widely available.

While a comprehensive health economics study is pending, researchers have already determined that the cost of continued treatment is much less than that of relapse.

“We now have evidence to show that heroin-assisted therapy is a safe and effective treatment for people with chronic heroin addiction who have not benefited from previous treatments. A combination of optimal therapies – as delivered in the NAOMI clinics - can attract those most severely addicted to heroin, keep them in treatment and more importantly, help to improve their social and medical conditions,” explains Schechter.

A summary report of the findings and background information on the study are available at: www.naomistudy.ca

 

NAOMI trial finds heroin more effective than methadone
By Jessica Werb
Health Straight Talk

Heroin-assisted therapy is a safe and highly effective treatment for people with chronic heroin addiction, according to the final data released by the North American Opiate Medication Initiative (NAOMI) today.

The three-year randomized controlled clinical trial, lead by Dr. Martin Schechter of UBC’s School of Population and Public Health, included 251 participants at sites in Vancouver and Montreal. Forty-five percent were given oral methadone, 45 percent were given injectable heroin, and 10 percent were given injectable hydromorphone, an opiate licensed for pain relief.

Those treated with heroin had a retention rate of 88 percent, compared to 54 percent for participants who received optimized methadone maintenance therapy.

Sixty-seven percent of those treated with heroin responded to treatment, compared to 47.7 percent of those treated with methadone.

Illicit heroin use declined in all patients, but was declined most sharply among those treated with injectable heroin or hydromorphone.

All participants reduced their involvement in crime and their spending on drugs, and all participants had health improvements, but those in the injectable heroin or hydromorphone group saw the greatest improvements overall.

The study also found that participants receiving hydromorphone did not distinguish it from heroin, and that it appeared as effective in treatment as heroin. However, researchers noted that the study was not designed to test this conclusively.

Given their less-than-enthusiastic reaction to InSite, I wonder how Stephen Harper and the RCMP are going to react to these findings?

Politicisation of Science

One of the main problems with society is the political system. It was while I was watching an interview with John Howard many years ago that it struck me how politics had taken a new turn. Howard said in an interview that the most important issue in Australia was the liberal party winning the upcoming election and they needed to focus all their efforts on achieving that win. Although it’s probably true for most politicians, I had never publicly heard this before. It had always been Australia’s future or the like that was a precursor for winning an election, not simply the need to win. By being able to openly say this in public, is it any surprise that more and more fundamentals of society would become political fodder in the quest to win an election? Those days are gone where politicians needed to appear logical. No longer did they take directions from facts, public needs or science. Basic freedoms were replaced by national security and the politics of fear. Common sense was replaced with idealism and patriotism. Science and medicine were replaced with religion and so called ‘family values’. Howard went on as PM for 3 terms over 11 and a half years. One of his profound contributions to science was silencing NGOs and government research organisations that had conflicting views to the official government spin. Research and facts became secondary to government policy and those who dared release conflicting data were faced with losing government funding. This led to the rise of groups like Drug Free Australia (DFA) whose sole purpose was to push the government’s own agenda that would normally be criticised by proper research groups. DFA were supporters of the US model that wouldn’t allow federal funding for programs that conflicted with modern christian ideology like safe sex education and needle exchanges. With most opponents now silenced in Australia, Howard had the opportunity to completely remove conflicting science from drug policy and the next step was to produce his own “research” which came via the Bishop Report - “The Winnable War on Drugs”. Luckily Howard was booted from office and the Bishop Report was doomed to bottom of the rubbish bin. Scarily, Howard had came so close to achieving the unthinkable and nearly implemented a non medical solution to a medical problem based on politics and moral/religious ideology. In the US, healthcare is an example of how medicine has become so politicised that it’s actual purpose has been overlooked and instead has become a political hot potato about socialism vs. right wing ideology. But science/medicine has been heavily politicised in nearly every country - abortion, nuclear power, alternative energy, mental health, creationism in science class etc. The two prime examples that stand out are climate change and drug policy. Both issues have been taken out of the scientific arena by the right because a pragmatic solution might upset their corporate interests or encroach on their safe, pseudo religious ‘family values’ ideology. Taking advantage of an upcoming election, a group of renown professors in Canada decided that they should write a letter to the major political parties and voice their concern. The politicisation of science had cost millions of lives worldwide and was risking the future of our planet. But can a group of experts actually get through to the decision makers? The letter is a real eye opener when you look at the content and you may start to realise how backward mankind has slipped considering how far we have progress scientifically.

Dear Sirs and Madam: We are a group of concerned scientists writing to call for the end to the politicization of science and related due processes in Canada. Below we highlight some recent examples of the mistreatment of science in Canada: • The closing of the Office of the National Science Advisor 1 • The misrepresentation of climate change science 1, 2 • The muzzling of Environment Canada scientists 3 4 • The cuts to and reorganizing of the Canadian Wildlife Service 5 • The political appointments to the board of Assisted Human Reproduction Canada 6 • The halting of the Prison Tattoo Pilot Study and the suppression of the results of this study 7 • The firing of the Head of the Canadian Nuclear Safety Commission 8 • The suppression and misrepresentation of research related to Vancouver’s Supervised Injection Site 9-11 The above represent blatant examples of instances when: • Systems developed to provide non-partisan scientific advice were undermined, interfered with, or dismantled for political reasons; • Science was interrupted, suppressed and distorted for political reasons; • Scientific uncertainty was manufactured in instances where none existed; • Reputable scientists were attacked because the results of their work were unpopular or inconsistent with the views of political parties; While science is not the only factor to be considered in political decision-making, ignoring and subverting science and scientific processes is unacceptable. In light of these concerns, we are calling on all political leaders to articulate how they will work to improve Canada’s track record with respect to the treatment of science and related due processes. Yours truly, Canadian Scientists Against the Politicization of Science Encl.: Name List of Signatories References: 1. Science in retreat. Nature 2008;451(7181):866. 2. Smith C. Climate scientist claims Stephen Harper's government has muzzled experts. The Georgia Straight 2008 September 25th, 2008. 3. Munro M. Environment Canada scientist told to toe the line. National Post 2008 January 31, 2008. 4. CBC News. Minister stops book talk by Environment Canada Scientist. 2006 April 6, 2006. 5. Reuters. Canada slashes spending on wildlife protection: CBC. 2007 September 19th, 2007. 6. Hebert PC, Attaran A. A plea for transparency in Canada's "new government". CMAJ 2007;176(5):601, 603. 7. Kondro W. Prison tattoo program wasn't given enough time. CMAJ 2007;176(3):307-8. 8. Curry B. Fired watchdog quits nuclear board. Globe and Mail 2008 September 23, 2008. 9. Wood E, Kerr T, Tyndall MW, Montaner JS. The Canadian government's treatment of scientific process and evidence: inside the evaluation of North America's first supervised injecting facility. Int J Drug Policy 2008;19(3):220-5. 10. Wodak A. Going soft on evidence and due process: Canada adopts US style harm maximization. Int J Drug Policy 2008;19(3):226-8; discussion 233-4. 11. Kerr T, Wood E. Misrepresentation of science undermines HIV prevention. CMAJ 2008;178(7):964. Sent to: The Right Honourable Stephen Harper, PC, MP Prime Minister of Canada The Honourable Stéphane Dion, PC, MP Leader of Her Majesty’s Loyal Opposition Mr. Gilles Duceppe, MP Leader of the Bloc Québécois Mr. Jack Layton, MP Leader of the New Democratic Party of Canada Ms. Elizabeth May Leader of the Green Party of Canada

Below is an article from Canadian Medicine. Canadian Medicine is the editors' news blog of Parkhurst Exchange, a monthly medical magazine based in Montreal, Canada.

Canadian researchers demand end to political interference Canadian Medicine Two can play at this game, it seems. Medical researchers and scientists upset by the "politicization of science" in Canada have decided to turn the tables by interjecting themselves into the political scene as the October 14 federal election draws near. A petition protesting the "recent mistreatment" of scientific research will be sent to all major federal political party leaders in the coming days, Canadian Medicine has learned. The petition was drafted by a group of doctors and researchers that has routinely butted heads with Stephen Harper's Conservative government over the last two and a half years: Julio Montaner (above), Thomas Kerr and Evan Wood. Dr Montaner has become an academic of worldwide renown as the recently appointed president of the International AIDS Society. The three men are all professors of medicine at the University of British Columbia, but they are best known for their roles at the BC Centre for Excellence in HIV/AIDS, which under their leadership has produced some of the world's top medical research on supervised-injection sites, focusing largely on the downtown Vancouver facility Insite. Insite has served as a flashpoint for the conflict between the Conservative government and scientists. Despite overwhelming evidence of Insite's benefits, the government withdrew funding and then fought a battle in court earlier this year to attempt to establish jurisdiction over the project so that it could shut it down. The attempt failed when a BC judge ruled that the federal government was not within its rights. Soon after that, Health Minister Tony Clement -- who asked the attorney general to appeal the BC decision -- went on the offensive, drawing considerable opposition from the medical community when he questioned the ethics of physicians who support supervised-injection. The conflict over Insite is not the only complaint the petition mentions. Others include: "the closing of the office of the National Science Advisor" "the misrepresentation of climate change science" "the muzzling of Environment Canada scientists" "the political appointments to the Board of Assisted Human Reproduction Canada" "the cuts to and reorganizing of the Canadian Wildlife Service" "the halting of the Prison-based Tattoo Pilot Study" In a letter dated October 6, addressed to "friends and colleagues," Drs Montaner, Kerr and Wood write: In light of our concerns we have prepared a letter addressed to the leaders of the federal political parties and have asked them to make clear the action they are prepared to take to end the politicization of science in Canada. We are inviting you to become a signatory to this letter. We will send this letter to all major media outlets in the coming days.

Prescribed Heroin Project 'Promising'

For many hardcore heroin addicts, the hustling begins first thing in the morning. They wake up with one thing in mind: How to get their next fix. Some turn to panhandling, prostitution or crime to come up with the cash for drugs. But a heroin study seems to have changed that for some Montreal addicts.

Prescribed Heroin Project 'Promising' Brett Bundale The Gazette June 2008

North America's first research study on medically prescribed heroin will wrap up in a few weeks. The goal of the North American Opiate Medication Initiative, funded by the Canadian Institute of Health Research, is to examine harm reduction and the treatment of illicit drug use.

The $8-million clinical trial started in 2005 in Montreal and Vancouver, the site of Insite, North America's only safe-injection site.

As the project winds down, Quebec is considering setting up a safe-injection facility in Montreal, Health Minister Philippe Couillard said Wednesday.

But unlike a safe-injection site, where addicts inject themselves with their own street drugs under the supervision of a nurse, the research study uses medically prescribed pharmaceutical-grade narcotics.

Although the findings will not be published until the fall, the preliminary results are promising, said Suzanne Brissette, one of the study's doctors and the lead investigator in Montreal.

"The cost effectiveness will be an important part of our findings," Brissette said.

In addition to the human costs, an untreated heroin addict costs Canada an estimated $45,000 a year in public health care, criminal justice and welfare.

Similar studies in Europe suggest prescribed heroin programs can save the public nearly $20,000 a year per addict, after research and clinical costs are factored in.

The North American study offered addicts information about how to avoid some of the risks of drug use, like using shared or unsterilized needles, and how to manage - if not kick - the habit.

Heroin users are at risk of developing abscesses, contracting such diseases as HIV/AIDS and hepatitis C, and other problems related to adulterated heroin sold on the street.

In Montreal, addicts were allowed to come to the clinic three times a day to get their fix.

"What was surprising was that, as their lives gained stability, many came only twice a day," Brissette said.

In addition, the maximum heroin dose allowed was about 400 milligrams, but on average addicts chose to take only 170 milligrams at a time.

"Because the heroin was free, people thought an escalation in use would occur. But this didn't happen," Brissette said.

The study followed a strict recruitment process.

"There was a fear we'd attract more users by giving out free heroin," Brissette said.

"The participants had to have repeatedly failed the standard treatment," Brissette said, which involves oral methadone, a drug similar to morphine, as a substitute for heroin.

Once selected, nearly half the participants underwent the standard methadone treatment. The other 55 per cent received either heroin or another opiate that is injected, hydromorphone.

Many users put on weight and some managed to find jobs, Brissette said.