When we are wired to opiates (heroin, morphine, oxycontins, percs) we need them in order to function.  We get very sick without them.  The problems of being "addicted" basically come from the fact that the drugs are pretty much illegal for us.  Therefore, we have to go through lots of hassles and dangers having to get the drugs we need from the illicit market.  They cost a lot, they may be of questionable quality, they are illegal, and there are dangerous health problems (such as HIV, HCV, and overdose).  

Although the propaganda paints us are losers and junkies, in fact, a whole lot of problems for addicts, as well as society because of heroin addicts, can be lessened when we are legally able to access opiates from doctors or clinics.  Although this flys in the face of the prevailing war on drugs (users) mentality, it fits quick well with common sense and pragmatic social policy.

As of 2007, methadone maintenance was still the only legally available long-term (more than 180 days) opiate treatment available in Canada. However, this has finally changed.

Since 2004 a pilot project for heroin maintenance, the NAOMI Study has been operating in Vancouver. Similar studies proposed for Toronto and Montreal have yet to get underway.

NAOMI Study Results Summary - results of first three years of project, 2008

Methadone

Below are links to some of the key documents regarding methadone treatment in Canada.  If you have any concerns about the practices in methadone clinics, you should consult these documents as a baseline to compare what is recommended. 

The guidelines in these documents are not the be-all or end-all of methadone practice.   In fact, they can and should be improved on.  However, for the time being they should be considered the basic minimum standards that methadone clinics in Canada should be adhering to.  Methadone patients need to formally complain about clinics who are not following these basic standards.

Best Practices - Methadone  - Office of Canada's Drug Strategy, Health Canada, 2002

Methadone Maintenance Guidelines - The College of Physicians and Surgeons of Ontario, 2001

Dispensing Methadone for Treatment  - Drugs Directorate Guidelines, Health Canada, 1994 (PDF format)

Use of Opiods in Management of Opiod Dependence - Therapeutic Products Directorate Guidelines, Health Canada, 1992

Mainstreaming Methadone Maintenance: the role of the family physician

Heroin

Supervised injectable heroin in England  - Lancet, 2010.

Heroin vs. Methadone as Opiate Substitution Therapy  - report in New England Journal of Medicine, August 2009

Heroin Studies Examined - overvies of the outcomes of 5 Heroin Trials worldwide, 2003

Randomized Injectable Opiod Treatment Trial - results of recent UK treatment model, September 2009

NAOMI study website - Canada, documents and video clips, 2005 ( username: naomi1  password: health )

NAOMI Study Results Summary - results of first three years of project, 2008

Opiate Drug Substitution and Maintenance Treatment - overview of various options for Vancouver and NAIMO Project, 2007

Heroin Assisted Treatment - The Swiss Experience, Report to Canadian Senate, 2001

Swiss Trials - External Review Panel's Findings, 1999

Prescribing Heroin - British Experience, 2003

Netherlands Clinical Studies - various studies up to 2003

Buprenorphine

Suboxone Approval News Release - Canada finally approves buprenorphine as a treatment option, December 2007.

Buprenorphine: a potential new treatment option - Canadian Medical Association Journal, 2006.

Austrialian study - 2003

Suboxone Education Program - education required to treat opiate dependent patients in Canada with SUBOXONE buprenorphine (as buprenorphine hydrochloride) and naloxone (as hydrochloride dihydrate), Schering-Plough Canada Inc., 2007.

Amphetamine / Cocaine / Stimulants

Prescribing Stimulants - International Journal of Drug Policy, July 1998

Dextroamphetamine for Cocaine-Dependence Treatment Journal of Clinical Psychopharmacology, Vol.21, No.5, 2001.

The Need for Speed: Substitute Prescribing to Amphetamine Users in Britain - Russell Newcombe, Researcher, Lifeline U.K., 2007

Substitution Therapy - Cocaine/Amphetamine - Drug and Alcohol Review, 2002

Decriminalization and Legalization

Portugese Decriminalization Experience, 2001-2009 - Glenn Greenwald, Cato Institute White Paper, 2009.

Thinking About Legalization - James Ostrowski, Cato Institute Analysis, 1989.

After the War on Drugs  - Transform Drug Policy Foundation. 2006.