Alberta researchers help launch study on opioid treatment

National group aims to determine benefits of Suboxone over methadone

Alberta researchers are set to play a key role in a newly launched national study that will compare the effectiveness of two treatments for patients who misuse prescription opioid medications.

The project by the Canadian Research Initiative in Substance Misuse will involve patients from seven sites around the country, including the opioid dependency clinics in downtown Edmonton and the Sheldon M. Chumir Health Centre in Calgary.

The group is hoping to recruit 276 patients, including 70 in Alberta. Researchers will follow participants’ progress on methadone or buprenorphine/naloxone — better known by the trade name Suboxone — for 24 weeks.

“We are doing what we call a pragmatic trial, which is not really designed to show whether the drugs are effective, but rather how can we understand how well they work when delivered in usual care,” said Cam Wild, a University of Alberta professor serving as one of the study’s investigators.

For decades, methadone has been the primary treatment protocol in Canada for patients with opioid use disorder, yet it carries a significant risk of overdose and harmful interactions with other drugs. As such, patients typically have to take a daily dose under the supervision of health professionals.

In contrast, patients can take Suboxone at home on their own, largely because it poses a lower risk of overdose and fewer sideeffects, Wild said.

Past studies involving heroin users have also shown that Suboxone is as effective as methadone in

(The study is designed to see) what happens when you offer patients take-home dosing that is more patient-friendly and requires less supervision.

stabilizing patients and reducing their use of the narcotic, he said. The new study will test whether the same is true for people misusing prescription opioids such as codeine, morphine and oxycodone.

“What this study really is designed to do — and for the first time deliver some Canadian evidence — is compare what we usually do with methadone, with what happens when you stabilize patients on Suboxone and offer them takehome dosing that is more patientfriendly and requires less supervision,” Wild said.

Suboxone is not as widely used in Canada as methadone — in part because it is more expensive — but the study’s researchers are hoping their work will provide evidence that it should be employed more often as a front-line treatment.

Both methadone and Suboxone are available in Alberta, and the government has been taking steps to increase access.

Approximately 7,700 Albertans used the therapies in 2016-17, but that number has since increased by at least 18 per cent, the province said. The use of Suboxone, in particular, has risen substantially over the last year.

Misuse of prescription opioids has become a growing concern for jurisdictions across the country grappling with an epidemic of opioid-related deaths.

While most fatal overdoses have been linked to illegally made narcotics purchased on the street — particularly illicit fentanyl — medication obtained through prescriptions is also playing a role.

Statistics show Alberta physicians have been dispensing opioid medications to patients at a higher rate than other provinces, though there is some recent evidence the trend is decreasing.