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The case for a heroin substitution treatment trial in Canada

B Fischer1, J Rehm

  • 1Addiction Research Foundation, Toronto, ON. bfischer@arf.org

Canadian Journal of Public Health = Revue Canadienne De Sante Publique
|February 12, 1998
PubMed

Insights

Heroin substitution trials in Canada are proposed to reduce harms from illicit opiate use. While methadone treatment helps, it is insufficient alone. Heroin substitution could significantly lower health and social costs.

Area of Science:

  • Public Health
  • Addiction Medicine
  • Epidemiology

Background:

  • Illicit opiate use in Canada results in significant harm and social costs.
  • Methadone substitution treatment is effective but underutilized in Canada.
  • Current methadone availability alone may not sufficiently mitigate harms from illicit opiate use.

Purpose of the Study:

  • To advocate for the establishment of a heroin substitution trial in Canada.
  • To investigate the potential of heroin substitution to reduce opiate-related harms.
  • To build upon existing research and intervention strategies for opiate use disorder.

Main Methods:

  • Analysis of the epidemiology of opiate use and related harms in Canada.
  • Review of international experiences with heroin substitution interventions.
  • Argumentation for a controlled heroin substitution trial based on evidence.

Main Results:

  • Methadone substitution, while beneficial, is insufficient to minimize all harms associated with illicit opiate use.
  • Expanding methadone access is in the public health interest but requires complementary strategies.
  • Heroin substitution trials offer a potential avenue for further harm reduction.

Conclusions:

  • A heroin substitution trial in Canada is warranted to explore its efficacy in reducing health and social costs.
  • Evidence suggests heroin substitution may offer significant benefits beyond current treatment models.
  • Further research through controlled trials is necessary to confirm the impact of heroin substitution.

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