Expert calls treatment of opioid addicts outdated

Canada’s use of methadone to treat fentanyl and other opioid abuse is dangerous and outdated, says a substance-abuse expert gathered with others in Banff mapping out addiction strategies.

Canada should follow other countries, including the U.S., that have moved toward using another drug, buprenorphine/naloxone to manage opioid addiction, said Dr. Cam Wild of the School of Public Health at the University of Alberta.

“Canada has fallen behind other countries in treatment — in many places, Suboxone is the first line of care,” said Wild, using buprenorphine/naloxone’s brand name.

Suboxone, he said, has proven much less lethal than methadone in jurisdictions where it’s been publicly used.

“It has much less ability to kill people … so we can convince the approval and treatment systems to update,” said Wild, who chaired the meeting of about 40 experts in Banff.

Also risky is the too-commonly-used approach of cold turkey in ending individual addictions, he said.

The comments came amid an accelerating death toll from the use of synthetic opioid fentanyl, which killed 343 people in Alberta last year, a third of them in the final quarter of 2016.

Wild called it an emergency but said the province’s refusal to declare it one is less important than the work it seems to be doing in combating the scourge.

But one of the reasons Canada has fallen behind is due to the longtime lack of a national network to tackle drug misuse issues.

Two years ago, the Canadian Research Initiative in Substance Misuse (CRISM) was created to do just that and is preparing to launch a nationwide study comparing the merits of methadone and Suboxone.

It will recruit 300 patients to take part in the study, about 70 of them in Alberta, said Wild, who’s part of the 500-member CRISM.

“It’s the first time methadone and Suboxone will be compared head-to-head,” he said of the study expected to begin this spring.

Alberta, he said, could also gain from safe injection or ingestion sites that have proven a success in places such as Vancouver.

Such measures allow addicts to access treatment networks in addition to plying their habits more safely, said Wild.