Providence and patients file constitutional challenge to Federal Government's decision

Providence and five patients launched a constitutional challenge to overturn a recent decision by the federal government that prevents the delivery of life-saving treatment to vulnerable addictions patients.

VANCOUVER, November 13, 2013 — Providence Health Care (Providence) and five SALOME patients launched a constitutional challenge today to overturn a recent decision by the federal government of Canada that prevents the delivery of life-saving treatment to vulnerable addictions patients.

Providence and the five patients filed a Notice of Civil Claim in the BC Supreme Court today jointly, requesting, among other things, a declaration that the new federal government regulations infringe on the Charter Rights, are unconstitutional, and should be struck down.

The patient plaintiffs are David Murray, Deborah Bartosch, Larry Love, Douglas Lidstrom and Charles English.

“To patients like me, diacetylmorphine (heroin) assisted treatment has proven to be life-saving and stabilizing,” said David Murray. “To deny this treatment and to go against all medical evidence – and even Health Canada’s own decision – is heartless and harmful.”

The legal action comes in the wake of Federal Minister of Health Rona Ambrose’s October 3, 2013 changes to federal regulations making diacetylmorphine a restricted substance under the Food and Drug Act, preventing it from being available through Health Canada’s Special Access Programme (SAP).

SAP is designed to let patients in exceptional cases get medications normally not available in Canada. This access is limited to patients with serious or life-threatening conditions on a compassionate or emergency basis when conventional therapies have failed, are unsuitable, or are unavailable. Through SAP, Providence doctors had requested – and received – access to diacetylmorphine for 21 of the participants exiting the SALOME research study in Vancouver, before the regulations closed off access to this treatment.

Diacetylmorphine can continue to be used for the ongoing SALOME study because permission had already been obtained by Health Canada, but cannot be used for clinical care for patients no longer in the study.

SALOME (The Study to Assess Longer-term Opioid Medication Effectiveness) is a clinical study, headed by Providence’s Centre for Health Evaluation and Outcome Sciences researchers, that tests alternative treatments for people with chronic heroin addiction who are currently not benefiting sufficiently from available treatments such as oral methadone.

SALOME compares two similar medications – diacetylmorphine, the active ingredient of heroin, and hydromorphone (HDM), a legal, licensed pain medication.

The study aims to determine alternative treatments for people with chronic heroin addiction not benefitting sufficiently from available treatments such as oral methadone.

The three-year trial is being completed in phases. So far, 75 participants have exited SALOME. Some of them have been transferred to methadone or drug-free programs and others onto oral HDM. Others critically require diacetylmorphine (heroin) assisted treatment.

Our highest priority is patient care – to provide the best, evidence-based treatments possible,” said Dianne Doyle, President & CEO, Providence Health Care. “The patients requiring diacetylmorphine are extremely vulnerable and have tried other treatments, such as methadone and detox, numerous times, but such treatments have not been effective. Diacetylmorphine (heroin) assisted treatment is a proven treatment option that is a last resort for people who have tried all other treatment options without success. Health Canada approved our doctors’ requests based on extensive evidence. The federal government’s decision curtailed this access and our patients’ rights to proper health care.”

The science supports this course of treatment. Six similar trials comparing medically-prescribed heroin and methadone (including NAOMI) involving more than 1,500 patients have provided unanimous evidence in support of the effectiveness of this treatment for long-term heroin-dependent individuals. Data is available from six countries: Switzerland, the Netherlands, Spain, Germany, the United Kingdom and Canada.

Heroin-assisted treatment has been officially adopted in the United Kingdom, Switzerland, Germany, Denmark and the Netherlands.

Providence has retained Joseph Arvay as legal counsel in the court action. The patients joining the action are represented by Scott Bernstein of the Pivot Legal Society. Arvay is a renowned Canadian lawyer who has argued numerous landmark cases involving civil liberties and constitutional rights, including Vancouver’s Supervised Injection Site case in the Supreme Court of Canada.

Allowing ideology to trump science – as was done by the federal government in this case – does not serve the needs of Canadians and is not consistent with our values,” said Arvay. “The precedent set in the Insite case should be guiding the federal government’s decision-making and how to meet the conditions and rights set out in our Constitution.”

Pivot Legal Society is a Vancouver Downtown Eastside-based non-profit organization that advocates on behalf of marginalized communities and persons across Canada through strategic litigation.

We are pleased to partner with Providence in this important case,” said Pivot lawyer Scott Bernstein. “With our combined dedication to advocating for fairness, justice and evidence-based treatment, we will have the best chance at defeating these harmful regulations.”

Along with the declaration, the individuals and Providence are asking the court to strike down the regulations and allow the SAP applications for SALOME participants to be considered under the old regulations until the constitutional issues are determined by the court.

Hear from Providence Health Care CEO Dianne Doyle about why this legal challenge is important:

Follow our legal challenge at #SalomeTrial on Facebook and Twitter.

Links to More Information:

Electronic Press Kit (including media backgrounders, B-Roll, photos, research papers, etc.):

Salome Website:

Public, Online Discussion of Legal Action (hosted by Providence):

About Providence Health Care
Providence Health Care is one of Canada's largest faith-based health care organizations, operating 16 facilities within Vancouver Coastal Health. Guided by the principle, “How you want to be treated,” Providence's 1,200 physicians, 6,000 staff and 1,500 volunteers deliver compassionate care to patients and residents in British Columbia. Providence’s programs and services span the complete continuum of care and serve people throughout B.C. Providence operates one of two adult academic health science centres in the province – St. Paul’s Hospital – performs cutting-edge research in more than 30 clinical specialties, and focuses its services on six “populations of emphasis”: people with cardiopulmonary risks and illnesses, HIV/AIDS, mental health, renal risks and illness, specialized needs in aging, and urban health.

For more information:

Dave Lefebvre
Senior Communications Specialist – Media Relations, Providence Health Care
Tel:  604-682-2344 extension 66987
Cell: 604-837-6003
Media Pager: 604-686-9983 (after hours & weekends)

Joseph J. Arvay, Q.C.