Grant: Travel Awards - Institute Community Support

Opioid dependence (i.e., heroin) is a chronic illness that poses harms to the individual, their family and the wider community. Oral methadone is the most widely used treatment for opioid dependence. For patients who do not respond to this and other existing treatments, a recent Canadian clinical trial has shown that medically supervised injectable diacetylmorphine (active ingredient in heroin) and hydromorphone (a licensed pain medication) are both safe and effective. Despite the benefit these treatments offer, there continues to be debate regarding whether patients with long-term opioid dependence are able to voluntarily consent to such research. This debate will be discussed at the Canadian Public Health Association Conference and will reference the recent Canadian clinical trial. The central ethical issue identified is beyond whether people with opioid dependence are able to voluntarily consent to injectable diacetylmorphine and hydromorphone treatment. Instead, the dilemma is rooted in the fact that people with opioid dependence may only be able to gain access to such life-saving treatments through their participation in clinical research. This debate therefore has implications for public health researchers studying new and innovative treatments outside the addictions research field. In such research, ethical solutions that address this underlying problem, while not limiting the possibility of research altogether, are needed. This debate and the lessons learned from this clinical trial will be shared with researchers, clinicians, decision makers and advocacy groups.