The fight against opioid addiction and overdoses in places such as Maple Ridge is being copied Canadawide.
Doctors who deal with the issue came up with a set of national guidelines that call for prescribing suboxone, a combination of buprenorphine and naloxone, as the go-to tactic for those struggling with opioid addiction.
And if suboxone doesn’t work, methadone is suggested.
And if neither works – daily, slow-release oral doses of morphine are recommended.
Fraser Health is already following that approach in Maple Ridge and across Metro Vancouver. The same guidelines were implemented across B.C. last June.
“Fraser Health already has opioid … treatment clinics across the region and more are slated to open this year,” the agency said.
Three Maple Ridge clinics, two on a fee-for-service basis, as well as Alouette Addictions Services, already offer such help.
“It’s a very effective way to support people with opioid replacements and we’re seeing great success with it,” said Annika Polegato, executive-director with Alouette Addictions.
People with an opioid dependency can make an appointment at Alouette and see a doctor within a week. The doctor can then issue a prescription for suboxone to help manage their addiction. Currently, there are doctors at the clinic two days a week with a third day being added later.
“We can get them in, usually within a week, and all of our services are free,” Polegato said.
She enourages those addicted to opioids, such as fentanyl, or casual users, to contact the clinic.
More than 80 per cent of the opioid overdoses take place inside someone’s home, she said.
“By all means, we want to reach those folks,” whether it be for a Narcan overdose kit, information on how to recognize or prevent an overdose, or to go on a prescription for suboxone or methadone.
Even those currently on a methadone program, for which they’re paying fees, can get the same service at Alouette Addictions, which has been fully funded by Fraser Health for the program.
The national guidelines “recommend strongly” against trying to get people to go through drug withdrawal in isolation, said an article in the Canadian Medical Association Journal.
The resulting loss of tolerance to drugs and high rates of relapse into addiction, “increases the risk of overdose death,” it says.
The Canadian Research Initiative in Substance Misuse devised the guidelines. Dr. Evan Wood with the B.C. Centre on Substance Use, is the lead author.
Fraser Health’s head of addiction medicine Dr. Nader Sharifi also helped develop the national guidelines.
Alouette Addictions started expanding its access to suboxone in mid-July and saw a growth in the number of clients up to total of 180 by September.
There is a broad range of people who suffer from opioid use disorders, chief medical health officer Dr. Victoria Lee said then. She cautioned against stereotyping opioid users as street-entrenched addicts.
While people talk about detox and treatment beds, when talking about drug addiction, Lee said the medical use of suboxone and methadone help people move away from opioids safely.
“If we remove that craving, [by providing methadone or suboxone] they can gain order back into their work and home life.”
In 2016-2017, Fraser Health had 2,476 patients with suboxone prescriptions. That compares to 1,362 patients in 2015-2016 – an 82-per-cent increase.
A total of 1,422 people in B.C. died of an illicit drug overdose in 2017, with 33 of those dying in Maple Ridge. The powerful opioid fentanyl was detected in 81 per cent of last year’s deaths, compared to about 67 per cent in 2016.
Fraser Health also launched a new community action team in February to deal with the issue of overdoses.