When hope is lost

Uncritical reporting of a Canadian heroin maintenance trial:

Though the formal results are not yet available, the program's anecdotal results suggest that the prescribed opiate treatment has helped some addicts improve their lives. "I think that what we can see from the experience over the past few years is that the treatment appears to be very safe," Schechter said. "And we can see that one of the things we consider, which is the retention rate or how well people stay in treatment is very high -- it's been 85 percent at one year."

The research team has heard stories about women who no longer turned to prostitution for drug money, Schneiderman said. Some participants said they had stopped committing crimes in order to buy heroin, and others had found employment. "I know that Dr. Schechter has told stories of people who have thanked him and said.

"This is the first time that I've gotten up in the morning and the first thing that I didn't think about was where I was going to get my next fix,"' she said. The study provided a reminder that for addicts, that next fix is the focus of their entire day, she said; when that need is removed, they have time to focus on other ones, like employment, housing or relationships.

Prescribing heroin to addicts is not a new idea. Several prescribed morphine and heroin clinics ran in the United States from 1919 until 1923, when the government shut them down. The UK has been prescribing injectable heroin and methadone to opiate addicts for decades now, though evaluation of the programs is limited. And in 1972, an inquiry commission in Canada recommended a heroin prescription trial for addicts who hadn't been helped by conventional treatments.

A decade-old Swiss study of 1,000 long-term opiate addicts had a 69% retention rate, with no deaths and more than half of those who dropped out entering other treatment programs. The participants showed improvements in physical health and social indicators, their rate of arrests and illegal income generation went down substantially, and their rate of employment doubled over the 18-month period of the study. Another trial that began in the Netherlands in 1998 targeted people in methadone maintenance therapy -- widely available in that country -- who were still using illicit drugs, and the researchers saw improvements in the participants' physical and mental health, drug use and social indicators.

Jim B. often refers to an old N.A. poster that said "The lie is exposed. We can recover." This is what happens when the lie goes unchallenged, we start providing palliative care for a treatable condition.