The B.C. Centre on Substance Use (BCCSU) has unveiled a vision for how legal heroin sales could take place in the province, as health officials continue to grapple with an unrelenting overdose crisis that kills roughly four people per day.

The idea is to create a heroin buyers club, or compassion club to sell regulated, pure heroin to people addicted to opioids.

Its architects — which include addictions experts, physicians, as well as drug users — drew inspiration from the cannabis compassion clubs in the 1990s, which provided access to medicinal marijuana, and the AIDS buyers clubs that helped people obtain medications that weren't yet approved during the height of the AIDS epidemic.

There is already limited access to a regulated supply of injectable opioids in Vancouver's Downtown Eastside — roughly 150 patients participate in the prescription program at the Crosstown Clinic, and a 50-person program to distribute Dilaudid tablets to crush up and inject is operating at an overdose prevention site.

In both cases, patients are given free opioids.

The BCCSU is proposing that a co-operative group be established to buy bulk, medical grade heroin from Switzerland to sell to doctor-assessed club members.

"We can really improve public health and safety by regulating the heroin supply and offering treatment and supports alongside that regulated market," said Dr. Evan Wood, the BCCSU's executive director.

"You could have, initially, hundreds of people brought into a program like this," said Wood. "Certainly it's a type of model that — if proven safe and effective — is scalable to other hard-hit neighbourhoods."

Dean Wilson is one of the people from the drug user community who has helped the BCCSU form a vision of what legal heroin sales could look like in B.C. (Rafferty Baker/CBC)

For Dean Wilson, who has spent the better part of the last 50 years as a heroin user, the idea is overdue. Wilson is one of the people with lived experience with drugs who has contributed to the plan.

"I was very lucky in the beginning of this epidemic ... but since [the beginning of] 2018, I guarantee you, I've lost 50 friends," said Wilson. "People are being poisoned to death."

According to Wilson, underground heroin buyers clubs have already popped up in the Downtown Eastside. Someone who finds a supply of uncontaminated heroin pools resources with 12 or 15 other users to buy a large quantity.

But Wilson said the informal clubs aren't sustainable, because they can't ensure the safe supply would last, and ultimately, the proceeds are all going to organized crime.

"You know we pay up to $200 a gram for heroin down here? That same gram sold in Switzerland, legally, is $3.80," he said, adding that the difference all goes to criminals.

Dr. Evan Wood, Executive Director of the B.C. Centre on Substance Use, says a model to sell regulated, pure heroin to people living with opioid addiction could save lives and also take money out of the pockets of organized crime groups. (Rafferty Baker/CBC)

For Wood, getting organized crime out of the system is a big part of the motivation behind the buyers club model. He thinks it could have a dramatic impact on public health, all while "waging economic war on organized crime."

The heroin buyers club will need federal support to get off the ground — importing and distributing heroin will require an exemption to the Controlled Drugs and Substances Act, but exemptions are available for research purposes as well as for urgent public health reasons.

Wood said, for now, the BCCSU is just getting the conversation started, but he hopes to see the vision become a reality over the next six months.

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