Fighting heroin addiction with heroin

Benedikt Fischer is claiming international headlines in a movement calling for unconventional methods to help drug addicts kick their habits.

“Historically, we’ve made drug use a criminal issue. That approach has been horribly ineffective. Drug abuse is, at root, a health problem for individuals and a public health problem, as well as one that leads to crime by design. We need to deal with it as such.”

Fischer is a key figure in the Interdisciplinary Health Research Team, a group of 15 researchers from across Canada focusing on illicit opiate addiction research, treatment and policy.

“Fighting drug addiction requires a merging of perspectives. I work with basic scientists, clinicians, epidemiologists, and public health specialists as well as researchers in criminology and law,” he says.

Fischer’s own skill set is remarkably broad. He is an associate professor in Public Health Sciences and assistant professor in the Centre of Criminology at U of T. He is also a research scientist and co-head of the Public Health and Regulatory Policy group at the Centre for Addiction and Mental Health (CAMH).

He is applying that background as one of the lead investigators in the North American Opiate Medication Initiative (NAOMI). The national study, the first of its kind in North America, is opening clinics in Vancouver, Toronto and Montréal that will provide pharmaceutical-grade heroin to hard-to-treat addicts under medical supervision. The study is being directed by the University of British Columbia, CAMH and U of T, and the Université de Montréal.

Many heroin addicts can kick their habit by using methadone, a synthetic replacement. “But for some long-time addicts, methadone doesn’t work. Through NAOMI, we will try to see if they can break their addiction with heroin treatment.”

Over 12 months, some addicts will receive methadone and others heroin, so the benefits of the two treatments can be compared. All clients will be helped with accessing the health care system, housing and job counselling.

“The goal is to see whether patients’ health will improve, their involvement in crime will decrease and if they can break their habit. The evidence from elsewhere is clear that once you stabilize people and get them into treatment, the results are positive. This has been proven in Switzerland and the Netherlands.”