Vancouver Mayor Sam Sullivan says that the government should support programs to supply maintenance doses of substitute drugs to cocaine and methamphetamine users to help them break their addiction, the Vancouver Sun reported Aug. 1.

Vancouver already has an experimental heroin-maintenance project underway, and Sullivan expects it to evolve into a full-scale program. "It's just a matter of time," he said. "You've just got to work it through the system. Now we've got to move into the next stage."

But cocaine is much more widely used than heroin in Vancouver, making it the next logical target. "I want a stimulant maintenance trial going," said Sullivan. "I've almost assumed [a heroin-maintenance program] is going to happen." About 88 percent of Vancouver's sex workers use stimulant drugs, he noted.

"Crack cocaine is the most expensive way to do coke, so that means people here are stealing from each other, fights are breaking out over almost nothing," said Ron Morgan, a peer counselor at the Insite heroin maintenance project. "A stimulant-maintenance program would help people stabilize their lives, stop them craving."

Sullivan says he already has significant funding offers from private donors to establish new maintenance programs. In the U.S., University of Texas researcher John Grabowski has also experimented with replacement drugs for cocaine and methamphetamine, such as Ritalin and dextroamphetamine. Studies found that the replacement drugs did help heavy stimulant users cut the amount of drugs they use and stabilize their lives, but Grabowski said it's unclear whether substitute drugs would cut crime.

"Whether they continue to engage in criminal activity, we have no way of measuring," said Grabowski. "Here's the problem: people expect too much of medications. If people walk in the door and their prime way of getting money is to be a thief, treating them is not going to change that."