Opioid treatment to be overhauled by Vancouver Coastal Health

Vancouver Coastal Health is revising the way they treat opioid addiction. One big change is that methadone will no longer be the treatment of first resort.

New strategy includes new drugs, more post-detox services

Fentanyl tablets seized by police. Vancouver Coastal Health's new opioid treatment strategy comes in the wake of increasing concern about prescription opioid abuse in the Lower Mainland. (ALERT)

Vancouver Coastal Health rolled out a new approach to opioid addiction today in the face of challenges with the methadone system, and the growing problem of fentanyl and other illict drug overdoses.

Dr. Evan Wood, the medical director of community addiction services for Vancouver Coastal Health, Stephen Quinn on The Early Edition that one of the biggest changes will be that methadone will no longer be the first choice for those seeking treatment for their addictions — instead, it will be a drug called Suboxone.

"Suboxone is an interesting medication in that it's a partial opioid agonist," he said. "Unlike heroin or methadone, it goes to the opioid receptor in the brain and blocks other opioids from activating those receptors, but itself is not a full receptor. So it's much less likely to cause a fatal overdose."

Dr. Wood also said that unlike methadone, Suboxone doesn't require a patient to go to a pharmacy every day for use, and can be taken at home.

Another part of the new approach is a review of detox services available which, says Dr. Wood, have been criticized for poor continuity of care.

"So someone goes through detox, their tolerance to opioids is decreased, and that can result in a catastrophic outcome in terms of a fatal overdose if someone relapses," he said. "So the guidelines make a very forceful recommendation against 'detox only' as a strategy."

"If someone wants off opioids altogether, The health care system really needs to come up with a strategy for ongoing addiction care so they can be closely monitored."

Dr. Wood says it's his hope that VCH will have a new system of addiction treatment by this time next year.

Mother, who lost son, applauds changes

One person who is applauding the new strategy is Pender Island resident Leslie McBain. She lost her 25-year-old son, Jordan, to a multiple drug overdose last February.

He got a back injury at work, and a doctor prescribed oxycodone for him.

"By the time he realized and we realized the extent of it, he was very firmly ensconced in that addiction," McBain told On The Coast's Gloria Macarenko. "The doctor basically cut him off, he said … 'I'm going to have nothing more to do with you.'"

She said that Jordan went into detox, came out clean, but then couldn't find support or counselling for him afterwards.

She saysJordan relapsed about three months after detox, and then died of an overdose of several prescription drugs.

McBain says she's hopeful the new guidelines will prevent other parents from being in her situation.

"Everything that's laid out in these guidelines is something he could have benefited from," she said. "At least there's counselling and support and just a general watching of the person until they're well. We could find none of that at the time."


To hear the interview with Dr. Evan Wood, click on the audio labelled: Dr. Evan Wood on new opioid strategy

To hear the interview with Leslie McBain, click on the audio labelled: Leslie McBain on losing her son to opioid addiction

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