This is the Cato Daily Podcast for Tuesday, April 2nd, 2019.

I'm Caleb Brown.

For many of those addicted to or dependent on opiates, heroin-assisted treatment works. That's according to Scott

McDonald the lead physician at the Providence Cross Town Clinic in

Vancouver, Canada. He argues that safe access to heroin can stem large

societal costs like death and violent crime.

We spoke during the Cato Institute's Harm Reduction Conference last month.

Prescription heroin is a treatment for a manageable illness, opioid use disorder, and no different

than diabetes or high blood pressure, no treatment will work for everybody.

And some people will acquire a more intensive treatment.

And we are fortunate that we have the full spectrum of tools available in Vancouver, Canada.

And that includes Suboxone, methadone, Cadian, a long-acting oral form of morphine, but there are some folks that just require

something more and a small percentage of people and that may be less than 4 to 8% of the total number that

require oral opioid agonist treatment for their disease. But some people

will require an injectable option.

Prescription heroin needs to be one of the tools in the toolkit.

And a small number of people are receiving that today in Vancouver, Canada.

Is it fair to call this heroin maintenance?

It's fair, but that's as fair as it is to call Suboxone or Methadone maintenance for opioid use disorder.

This really is just a chronic manageable illness.

Heroin assisted treatment, diamorphane is just one of the tools to manage that

illness. And the people that have this illness, if they're not engaged in care, are at huge

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