If someone asked for your opinion on how to deal with the widespread use of – and overdoses on – heroin, what would you suggest? Tougher laws, better border security, more money for law enforcement? How about making it available by prescription? It sounds crazy, but in Vancouver, British Columbia, Canada, one clinic is doing just that.

The idea is that if people are going to use heroin anyway – and all evidence points to there being no end in sight – they might as well do it safely. It’s like the idea behind safe injection sites, where people can use injectable drugs in a clean, safe place with new needles, reducing the risk of injury and disease. When you buy heroin on the street, you also have no way of knowing how potent it is or what it may have been laced with. Many people who overdose on heroin have gotten a batch laced with fentanyl. Fentanyl is a synthetic opioid that is thirty to fifty times as strong as heroin, and it’s one of the drugs implicated in the death of the musician Prince. When it’s mixed with heroin, the drug becomes so potent that users can die from the same dose that normally only gets them high.

At this clinic that dispenses prescription heroin, called the Providence Crosstown Clinic, users know that the drug isn’t contaminated or mixed with anything, and the risk of overdose is much lower. This is especially true because there are medical staff nearby, monitoring in case anything goes wrong. Crosstown offers opioid users medical-grade heroin, called diacetylmorphine. They inject it under supervision, and nurses stand at the ready with the overdose antidote naloxone and oxygen tanks in case of an emergency.

Since 2011, about 200 patients have received the medical grade heroin at the clinic, and none of them have died. Nor has anyone died at a prescription heroin clinic in other parts of the world where they exist, including Switzerland, Germany, and the Netherlands. Switzerland started its programs in the 1990s, and there are now 21 clinics and one prison that use prescription heroin as a therapy. Crosstown remains the only one of its kind in North America.


The scientific research backs it up – these clinics save lives. However, they’re not for everyone, and they’re essentially a plan of last resort. According to one review of six randomized trials, what it calls supervised injectable heroin (SIH) treatment is effective for “entrenched heroin users who have not responded to standard treatments such as oral methadone maintenance treatment (MMT) or residential rehabilitation.” This is promising because medication-assisted treatments don’t work for everyone – up to 40 percent of opioid users don’t respond well to methadone or buprenorphine.

If you or a loved one need help with quitting drugs or alcohol, consider Asana Recovery. We offer medical detox, along with both residential and outpatient programs, and you’ll be supervised by a highly trained staff of medical professionals, counselors, and therapists. Call us any time at (949) 438-4504 to get started.