Heroin Maintenance: SALOME Trials Set to Begin in Vancouver

In the Chronicle's review of the top international drug policy stories of the year last week, the slow spread of heroin maintenance was in the mix. This week, it's back in the news, with word that a new Canadian heroin maintenance study in Vancouver is about to get underway.

Hastings St., on Vancouver's Downtown Eastside (courtesy vandu.org)
The Study to Assess Longer-term Opioid Medication Effectiveness (SALOME) will choose a Downtown Eastside location next month and begin taking applications from potential participants in February, according to a Tuesday press release from the Inner Change Foundation, which, along with the Canadian Institutes of Health Research, is funding the trial. With selection of participants supposed to last only three weeks, that means SALOME could be underway by March.

SALOME will enroll 322 hard-core heroin addicts -- they must have been using at least five years and failed other treatments, including methadone maintenance -- in a year-long, two-phase study. During the first phase, half will be given injectable heroin (diacetylmorphine) and half will be given injectable Dilaudid® (hydromorphone). In the second phase, half of the participants will be switched to oral versions of the drug they are using.

The comparison of heroin and Dilaudid® was inspired by unanticipated results from SALOME's forerunner, NAOMI (the North American Opiate Medication Study), which began in Vancouver in 2005 and produced positive results in research reviews last year. In NAOMI, researchers found that participants could not differentiate between heroin and Dilaudid®. The comparison of success rate among injection and oral administration users was inspired by hopes of reducing rates of injection heroin use.

SALOME was also supposed to take place in Montreal, but Quebec provincial authorities effectively killed it there by refusing to fund it. SALOME researchers have announced that it will now proceed in Vancouver alone.

With an estimated 5,000 heroin addicts in the Downtown Eastside and a municipal government that has officially embraced the progressive four pillars approach to problematic drug use -- prevention, treatment, harm reduction, and law enforcement -- Vancouver is most receptive to such ground-breaking research. It is also the home of Insite, North America's only safe injection site.

The NAOMI and SALOME projects are the only heroin maintenance programs to take place in North America. Ongoing or pilot heroin maintenance programs are underway in Britain, Denmark, Germany, the Netherlands, Spain, and Switzerland.

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Heroin Maintanance program in Vancouver (SALOM)

Vancouver is the most progressive city in North America, so I am not surprised they are funding a heroin maintenance trial.
Why, oh why, can't the United States learn from Europe and Canada how to stop criminalizing opiates and stop the massive flow of American cash to the big drug overlords?
If just 10% of the cash spent on the "War on Drugs" went into working on alternative policies for heroin addicts, such as safe injection sites, heroin trials, etc and the police quit arresting and prosecuting the addict that deals just to pay for their own addiction-we would be so much closer to ending the "Drug Problem" and be a part of the solution.
A lot of addicts are born with a low production of endorphine- like transmitters in our brains. A lot of opiate addiction is self medicating for that deficiency, as well as depression (perhaps caused by that very deficiency?) and other mental health or childhood traumas, or adult traumas such as fighting a war.
Right on Vancouver!!!

This time

[email protected],Vancouver,B.C.Canada I tried to get on the NAOMI trial and was told to wait that there was going to be an extended trial and I should apply then.With 40 years of opiate addiction the fact that I had a roof over my head disqualified me for some reason.Like every addict on the planet I want to be on this trial.I have 35 years of advocating for just such a trial but that was of no consequence when Naomi was here.I think my success at beating urinalysis at the methadone clinic was also a factor.They say if you want something bad enough.I have always felt that living in Vancouver was the best thing for a heroin addict.SALOME,here I come.

naomi project

    too bad you didn't get into the naomi project but having been in the latest project, (salome) I know that allot of people fell through the cracks and got into the program without ever being to detox and rarely if ever fixed. Pissed me off a little but you know nothings perfect. I'm now waiting to get back on due to the court injunction. This few month wait is pissing me off a little too since I'm constantly hoping I can stop the money flow when I know it doesn't have to be that way. Getting on to the western European drug management programs just make so much more sense than the "war on drugs" failed policy.

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