While activists and healthcare professionals continue to fight for the legalization of marijuana, or at least its rescheduling, prescription heroin is now legal in all of Canada as a way to manage addiction.

The quiet approval by the Canadian government is already in effect and have made the dealings of Crosstown, a clinic that has a heroin-maintenance program, completely legal and regulated. The clinic is the first of its kind to have this type of program in North America, but it follows the structure of other clinics in some European nations.

The use of medical-grade heroin is only allowed for patients who have a severe addiction to opioids and have not responded to other traditional treatments. Canada’s health department, Health Canada, said this of the decision:

“A number of countries have allowed doctors to use diacetylmorphine-assisted treatment to support the small percentage of patients with opioid dependence who have not responded to other treatment options. There is also a significant body of scientific evidence supporting its use.”

Diacetylmorphine is the name for pharmaceutical-grade heroin and health practitioners and medical facilities can now apply to use the substance in their facility. Physicians will have to apply to Health Canada to be allowed to use the heroin, and nurses will have to inject the drug into the patient 2-3 times per day.

Opponents of the new law have pointed out that treating addicts in this way will not help their condition because the objective isn’t to ween them off over time; instead, it’s to keep addicts controlled when all else fails and physicians believe that the patient can’t be helped.

While it’s easy to oppose the treatment, proponents are typically the healthcare professionals that actually treat these patients and understand what they’re working with. Scott MacDonald, the lead physician at the Crosstown Clinic, has been treating patients since 2005 and his clinic sees 52 patients regularly, operating a court-ordered exemption before the law was passed. MacDonald says some of the people he sees have been addicted to heroin for over 50 years and that traditional treatments have failed numerous times on them.

Other positives for the treatment include patients appearing to be healthier, and their participation in the program significantly decreases their involvement in criminal activities, as they no longer need to get their fix somewhere else.

Still, in general heroin treatments are just as addicting as the drug itself. An anonymous person spoke on Wednesday about being on methadone on Humans of New York and said,

“It doesn’t get you high like heroin, but it takes away the urges. But it’s like liquid handcuffs because the withdrawals are just as bad. If I stop for twenty-four hours, it feels like fire in my bones. And they only give you one dose at a time. So I get to the clinic every morning at 6am, and there are already one hundred people in line.”

On Prime Minister Justin Trudeau’s agenda is to also make marijuana legal by next year; he already has a special team to determine how it will be regulated, sold, and taxed. Marijuana has also proven to be an effective treatment in opioid addiction.

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