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Judge allows prescription heroin injunction

Judge allows prescription heroin injunctionFrom left to right, Providence Health President and CEO Dianne Doyle, David Byres, Providence vice president of Acute Clinical Programs, lawyer Joseph Arvay, representing Providence, lawyer Adrienne Smith, of the Pivot Legal Society, and lawyer Angela Juba, representing Pivot, attend a news conference after the B.C. Supreme Court re-established access to diacetylmorphine (heroin) assisted treatment following a 2013 change by the federal government classifying it as a restricted substance, in Vancouver, B.C., on Thursday May 29, 2014. THE CANADIAN PRESS/Darryl Dyck

VANCOUVER - A group of addicts in Vancouver who were part of a clinical trial examining the use of prescription heroin have won a temporary injunction that will allow them to continue accessing the drug at least until a court challenge is heard.

The ruling, issued Thursday by a B.C. Supreme Court judge, is the second time in recent months that courts have interfered with Ottawa's attempt to rein in the medical use of otherwise illegal drugs.

Five people filed a lawsuit last fall alleging the federal government had violated their charter rights by denying access to prescription heroin to treat their addictions.

Those patients received the heroin during a clinical trial, but once they left the trial last year, their doctors asked for approval under a special Health Canada program to continue prescribing the drug.

Health Canada initially granted the approvals, but Health Minister Rona Ambrose quickly introduced new regulations to stop such approvals. The patients who were approved have not received any more prescription heroin and subsequent applications have been rejected.

A B.C. Supreme Court judge issued an injunction exempting the patients from the updated regulations until the case goes to trial, likely next year.

Joseph Arvay, a lawyer who is representing the patients, said the federal government's decision was not based on scientific research that has shown prescription heroin is an effective treatment for patients suffering from severe addiction.

"What was fundamentally wrong with the minister's decision is failing to understand that heroin treatment is a treatment, and it's not just providing the addicts with a drug of their choice," Arvay told a news conference Thursday.

"It (prescription heroin treatment) gives them an entry into the health-care system that they don't otherwise have. They're dealt with by social workers and psychologists, and people help them to deal with all the ramifications of their addictions."

The plaintiffs in the case all took part in clinical trials conducted by Providence Health Care, which operates St. Paul's Hospital in downtown Vancouver and is also involved in the lawsuit.

The first trial, the North American Opiate Medication Initiative, or NAOMI, took place in Vancouver and Montreal between 2005 and 2008. It compared the effectiveness of pharmaceutical-grade heroin, known as diacetylmorphine, and oral methadone. Two of the plaintiffs were NAOMI participants.

The Study to Assess Longer-term Opioid Medication Effectiveness, or SALOME, began in 2011. The study is comparing the effectiveness of hydromorphone, a synthetic drug approved for use to control pain, and pharmaceutical heroin in treating severe addiction. All five plaintiffs took part, exiting the program last year.

Doctors applied to Health Canada for special permission to prescribe heroin to 21 former study participants, including the five plaintiffs.

The updated regulations weren't retroactive, but the patients who were already approved still could not get the prescription heroin because the supplier didn't want to distribute the drug to the patients until the legal questions were cleared up.

Arvay said the injunction means all patients who have participated in the clinical trials can now apply to Health Canada for special access if their doctors believe prescription heroin will benefit them.

Health Canada said it plans to study the injunction before deciding how to respond.

"Dangerous drugs like heroin have a significant impact on Canadian families and their communities," said an email statement from department spokesman Sean Upton.

"We will continue to support drug treatment and recovery programs that work to get Canadians off drugs in a safe way."

The court ruling comes two months after a Federal Court judge issued a temporary injunction that disrupted Ottawa's plans to overhaul the medical marijuana system.

New regulations took effect in April, shifting marijuana production to commercial producers and attempting to prohibit patients from growing their own pot.

A group of patients launched a legal challenge, arguing they have a constitutional right to grow their own marijuana for medical use.

A judge issued an injunction to allow patients who were previously approved to grow their own pot to continue doing so while the court case proceeds.


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