Fischer B, Rehm J
Addiction Research Foundation, Toronto, ON.
Can J Public Health. 1997 Nov-Dec;88(6):367-70. doi: 10.1007/BF03403907.
Illicit opiate use in Canada causes considerable harm and social cost. Methadone substitution treatment, which has been proven effective in reducing the negative effects associated with opiate use, has been used in Canada, but so far only on a small scale. Recent research suggests that, while expanding the availability of methadone substitution is certainly in the public health interest, it would not be sufficient in itself to reduce to a minimum the harms from illicit opiate use. On the basis of the epidemiology of opiate use and of related harms, and building on the experience of intervention efforts currently underway elsewhere, this paper argues for the establishment of a heroin substitution trial in Canada. Such a trial should have the goal of investigating the potential of heroin substitution to significantly reduce the health and social costs to Canadians from illicit opiate use.
在加拿大，非法使用阿片类药物造成了相当大的危害和社会成本。美沙酮替代疗法已被证明在减少与阿片类药物使用相关的负面影响方面有效，加拿大也已采用该疗法，但迄今为止规模较小。最近的研究表明，虽然扩大美沙酮替代疗法的可及性无疑符合公共卫生利益，但仅靠这一点本身并不足以将非法使用阿片类药物造成的危害降至最低。基于阿片类药物使用的流行病学情况以及相关危害，并借鉴目前其他地方正在进行的干预措施的经验，本文主张在加拿大开展海洛因替代试验。这样一项试验的目标应该是调查海洛因替代疗法在显著降低非法使用阿片类药物给加拿大人带来的健康和社会成本方面的潜力。
