Alberta welcomes greater methadone access in opioid battle
The federal government’s plan to potentially improve access to methadone is a major step forward as Alberta tries to increase the number of drug users receiving treatment, says a top provincial health official.
Last week in Calgary, federal Health Minister Ginette Petitpas Taylor announced a number of actions to combat the country’s opioid crisis, including consultations to determine whether the current special exemption needed to prescribe methadone is a barrier to accessing treatment.
Methadone is used as both a pain reliever and as a detoxification and maintenance drug to treat opioid addiction because it reduces withdrawal symptoms.
Dr. Kristin Klein, Alberta’s deputy chief medical officer of health, applauded the federal commitment, saying the current restriction on methadone prescription is “just an extra administration barrier in my mind.”
“Really, it’s just another medication that is treating people that have a health issue,” said Klein, the co-chair of Alberta’s opioid emergency response commission.
The province has been boosting the number of patients with substance-abuse problems receiving either methadone or norbuprenorphine/naloxone in medicationassisted treatment. The number has gone up from about 2,600 in 2013-14 to 4,000 in 2016-17.
“We’re looking to increase that by several thousand more because we know that there is an unmet need and more people that could be accessing this treatment that currently aren’t,” said Klein, noting that increasing the number of physicians who can prescribe methadone and expanding access into primary care would help.
More than 3,000 people could die across Canada because of the opioid crisis this year. In Alberta, there were 315 deaths related to the opioid fentanyl from Jan. 1 to Aug. 12.
Petitpas Taylor also promised that Ottawa would consult on whether to increase access to prescription heroin outside of hospital settings as a treatment option, but Klein said that would have little effect in the near term in Alberta. There is currently no use of prescription heroin in the province.
The federal government is also supporting a pilot program in British Columbia to provide safer alternative opioids, such as Dilaudid or hydromorphone, to users. Alberta, however, will be launching its own pilot hydromorphone program in Edmonton and Calgary.
The Trudeau government is also authorizing safe-consumption sites to provide drug-checking services to test the safety of street drugs brought in by users and to streamline the approval process for temporary overdose prevention sites.
There is currently one safe-consumption site in Alberta operating temporarily on the grounds of Calgary’s Sheldon M. Chumir Health Centre, while a permanent site is being constructed within the facility. A further four safe-consumption sites in Edmonton and one in Lethbridge have been approved.
Klein said she doesn’t expect drug-checking to be introduced at the Chumir facility in the shortterm, though officials will watch how the service works at B.C. sites where it is offered.
We know that there is an unmet need and more people that could be accessing this treatment that currently aren’t.
After funding needs-assessment studies for safe-consumption sites in Fort McMurray, Grande Prairie, Edson, Red Deer and potential additional sites in Calgary, the opioids commission is expecting there will be new applications brought forward for review in January.
“I’m anticipating that several additional cities will be coming forward with proposals in the coming months,” said Klein, noting that there may now be proposals for temporary overdose prevention sites.
Dan Ryan, president of the Alberta Medical Association’s addiction medicine section, said in an email statement that the provision of safe-consumption sites and opioid replacement — along with the use of the Naloxone overdose antidote — will help save lives.
“We are supportive of any and all measures that may reduce the devastating consequences being seen from opioid abuse, specifically from fentanyl in its many forms,” Ryan said.