A recent book by Professor Lucas Richert, a historian of pharmacy at the University of Wisconsin-Madison, sheds light on the history of drug regulation and advocacy. The book, titled "Strange Trips," dedicates its first chapter to Dr. Ken Walker, known by his pen name, W. Gifford-Jones, MD.

In the late 1970s and early 1980s, Dr. Walker emerged as a prominent advocate for the legalization of medical heroin in Canada. He was motivated by personal experiences, having lost friends to cancer and witnessed his patients endure severe pain. At that time, heroin was commonly used in Britain for pain management, but Canadian patients were denied access. Dr. Walker argued that this restriction was not based on scientific evidence but rather on political decisions.

Richert's book captures the tension between evidence and opinion in drug policy debates. One expert noted, "heroin is particularly good at inducing opinions which conflict with all the evidence and ‘evidence’ that is then moulded to fit the opinions." Dr. Walker's campaign prompted Canadians to consider whether terminally ill patients should be denied effective pain relief due to the stigma surrounding heroin.

Dr. Walker's advocacy extended beyond his writing. He gathered over 30,000 signatures on a petition and received an additional 20,000 letters of support, which he presented to Health Minister Monique Bégin in Ottawa. He also traveled to the UK to gather information, speaking with healthcare professionals and patients. He noted that officials from Scotland Yard dismissed concerns that medical heroin in hospitals would lead to increased crime, stating they had more pressing issues to address.

When political progress stalled, Dr. Walker intensified his efforts by placing full-page advertisements in newspapers. One ad featured the provocative headline, "Will the real hypocrites please stand up," which drew public attention but alienated some in the medical community.

Support for Dr. Walker's position grew, with editorials in major newspapers endorsing his call for change. The Canadian Medical Association eventually backed the legalization of medical heroin after discovering that Canada had been pressured by the United States to ban the drug decades earlier. Dr. William Ghent, a prominent figure in the CMA, remarked, "We followed the US like sheep, and now, like sheep, we’ve got their manure to deal with."

By the mid-1980s, the Canadian government approved new trials, leading to the eventual legalization of heroin for severe chronic pain and terminal illness. While this marked a significant shift in drug policy, it did not resolve all debates in palliative care. Experts continue to argue that the focus should extend beyond just drugs.

The discussion around drug policy remains relevant today, particularly with emerging research on psychedelics like psilocybin as potential treatments for end-of-life distress. Patients still face similar challenges related to politics, stigma, and delays in access to these therapies.

Richert's book serves as a reminder of the ongoing struggle for compassionate drug policies. It highlights the importance of understanding history in shaping current debates. For those interested in more details, a synopsis of Richert’s chapter is available in the Canadian Medical Association Journal.