Canadian Drug Policy Coalition
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  Monday, September 23, 2013


Re: Special Access Requests and Permanent HAT programs

SNAP (SALOME/NAOMI Patients Association) is a unique, independent group of past and current participants in the NAOMI trial and the current SALOME trial who strongly oppose Health Minister Rona Amborse’s September 20, 2013 statement condemning the recent decision by Health Canada to approve Special Access Requests submitted by physicians for patients exiting the SALOME trial.

SNAP is comprised of the only patients in North America to be part of two heroin-assisted treatment (HAT) clinical trials. As a group we came together in January 2011 following the end of the NAOMI clinical trial (formally NAOMI Patients Association). Now our membership is also comprised of SALOME patients. We meet weekly in the Downtown Eastside of Vancouver to provide support, education, and advocacy to our members and the public.

It is indisputable that heroin-assisted therapy is an effective and safe treatment that improves physical and psychological health when the participants are receiving treatment [1]. For an excellent summary of the scientific evidence about heroin-assisted treatment, including the Canadian NAOMI trial, see Strang, Groshkova, and Metrebian’s 2012 overview of HAT programs and clinical trials around the world [1].

Outside Canada, heroin-assisted therapy is offered in a number of countries and none of these programs shut down following their study stage; due to the fact that study results were positive, these programs continued on a permanent basis and/or participants were granted further HAT on compassionate grounds. The Netherlands HAT randomized trial conducted over four years demonstrates that the longer a patient is offered HAT, the better the chance of continued good health (in contrast to those patients with only one year of HAT. Thus, continuation of HAT is essential.

The Canadian NAOMI trial is the only heroin-assisted treatment study that failed to continue offering HAT to its participants when the trial ended in Vancouver. We do not want to see the same outcome for the SALOME trial. Currently, SALOME patients are being offered oral hydromorphone when they exit the trial.  However, there is currently no scientific evidence to support this treatment option for opiate addiction in the doses required; thus we urge you to reconsider your comments and to support Health Canada’s decision to grant special access to heroin for patients exiting the SALOME trial. We also urge Canadians to support the immediate establishment of a permanent HAT program in Vancouver, BC.

As patients who have benefited from the NAOMI and SALOME trials, we have first hand experience about the efficacy of HAT. Because the evidence demonstrates the benefits of such treatment, we urge the Health Minister to support our special access requests and access to a permanent HAT program. To do otherwise would breach our Charter rights as patients needing medical care.

SNAP (SALOME/NAOMI Patients Association)

380 East Hastings Street
Vancouver BC
V6A 1P4
Dave Murray (founder and facilitator of SNAP): 778-320-5823

[1] Strang, J., Groshkova, T., & Metrebian, N. (2012). New heroin-assisted treatment: Recent evidence and current supervised injectable heroin treatment in Europe and beyond. Luxembourg: Insights, European Monitoring Centre for Drugs and Drug Addiction

The Canadian Drug Policy Coalition is a partner project with the Centre for Applied Research in Mental Health and Addiction (CARMHA), a research centre based at the Faculty of Health Sciences at Simon Fraser University's Vancouver campus. 


  Canadian Drug Policy Coalition
C/O Centre for Applied Research in Mental Health and Addiction
Simon Fraser University
#2400 - 515 West Hastings Street
Vancouver, BC V6B 5K3

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