December 4, 1998

I would like to clarify the position of the Canadian Psychiatric Association as represented in the September 18 article "Canada Considers Trial of Heroin Prescribing."

At the time of the interview, I believe I made it clear that the Canadian Psychiatric Association (CPA) had no position on this matter but that it would consider it at its annual meeting in Halifax two weeks later. The board of the association, at its meeting on Friday, September 18, adopted the following motion to be forwarded to the Minister of Health and Health Protection Branch in Canada:

"That the investigation of the prescription of heroin for opiate-dependent individuals follows the same approval protocol in practice for the use of any new drug in Canada."

The CPA certainly views the matter of heroin prescribing with "great interest" but to view it "favorably" is a misrepresentation. This article must have confused my colleagues in the medical, psychiatric, and addiction medicine societies in Canada and the United States, who have heard me bring the matter to their attention with concern, seeking their feedback on the empirical evidence available to ensure an informed and safe recommendation for the benefit of our patients. The CPA motion, I believe, is close to a recommendation from the APA Council on Addiction, which debated the matter fully and to my satisfaction at APA's fall component meetings in September.

N. el-Guebaly, M.D.
President
Canadian Psychiatric Association