Alberta fentanyl wait lists could be deadly: expert

The day after news of another fentanyl pill seizure, questions are being raised about whether users of the deadly drug can get help for their addictions quickly enough.

Province insists it is doing everything possible to fight the dangerous drug

The drug fentanyl was detected in 274 overdose deaths in Alberta in 2015. (Alberta Law Enforcement Response Teams/The Canadian Press)

She remembers being told it would be fun to try, that one time couldn't hurt.

So she crushed up the little green pill and took it.

About a year later, the young woman we'll call Jane is in the grip of a desperate fentanyl addiction.
CBC's Gareth Hampshire spoke with one addict who shared her first-hand account of how the opioid has taken over her life. 0:48

"It's a very dangerous drug," she said. "It's very, very bad, and I hate that I've become so addicted to it."

Now she can't get through the day without the deadly drug, said to be up to 100 times more potent than morphine.

"It's really addictive," she said. "You do it, and your body just gets so used to it, and you get withdrawals and you just need it."

She has tried to stop but felt so sick as a result, she went right back to it.

"I'm not proud of it at all," said Jane, 20, who is now determined to kick a habit that has ruined her life.

"I lost everything, I lost my family, I lost my friends," she said.

Jane is now getting help from iHuman, an Edmonton inner-city agency, where an addictions worker is trying to help her find the best treatment.
Jane says after using fentanyl for about a year she's lost everything and "wants her life back"

She has been told a bed will be available for a year-long residential treatment program in Edmonton. The catch is, she's on a waiting list and it could take a month.

The average wait in 2015/16 to get into one of Alberta Health Service's nearly 900 addiction-related residential treatment beds was about 20 days across the province.

Public Health Emergency suggested to speed up access to treatment

Addictions and public-health specialist Dr. Hakique Virani agreed with Jane the wait is too long, and potentially dangerous for people who need urgent help.

"Twenty days could reflect 200 doses of opiates," said Virani, adding any single dose could be lethal.

The dramatic increase in the number of overdose deaths linked to fentanyl, from 29 in Alberta in 2012 to 274 in 2015, should lead the province to declare a public health emergency, said Dr. Virani.

"If we were to declare an emergency and mandate that our health authorities allocate resources for immediate access to treatment for people who are struggling, I think we'd see that change," he said.

The Alberta government has said it's already doing everything it can to try to shorten wait times and allocate resources for treatment.

It considered declaring a public health emergency in the fall, but after taking legal advice decided not to change its approach to the fentanyl crisis.

Province says it is doing what it can to shorten wait times

Associate minister of health Brandy Payne said 50 new treatment beds have been opened or announced across the province since February.

In addition, Payne said a $3-million grant has been provided to Alberta Health Services to open more opioid-replacement treatment clinics.

Those provide the drugs methadone or suboxone as treatment to try to stabilize people in an outpatient setting.

Payne said she understands the frustration of families waiting for beds.

"It's challenging for families and their loved ones as they wait for access to a medical bed," said Payne. "And certainly we want to do what we can to help ensure that when someone is ready for treatment they're able to access that treatment as fast as possible."

Payne pointed to a new opioid-replacement treatment clinic that  opened in Cardston on May 24.

The area was considered high need, and has already taken in nine patients, with four to five more being assessed and added each week.

Life saving naloxone kits part of response on 'many fronts' 

The department said Alberta was only the second province in the country to make the antidote naloxone available without a prescription.

Naloxone can save lives if it's given quickly enough. Between May 13 and June 2, a total of 164 naloxone kits were handed out by pharmacies without prescriptions.

Dr. Virani said the province should get credit for what he described as "strong leadership" when it comes to naloxone, but stressed that naloxone is not a treatment for addiction.

He said the gravity of the fentanyl crisis demands a faster response.

A lot of research shows that the outpatient model of opioid-replacement treatment, where out patients can get methadone and suboxone, is effective but also difficult to access because of wait times, he said.  

"The last I heard in Calgary, you know, in excess of eight weeks," said Dr. Virani.

AHS said the opioid-dependency program Dr. Virani is talking about in Calgary has 385 clients, with 31 more on a wait list of about 40 days.

In Edmonton, 481 clients are in the opioid-dependency program, which has a smaller waiting list of six clients, meaning the wait is much shorter, at around seven days, according to AHS.

The province said AHS can connect people to other supports as they wait for beds.

Jane relies on the support from iHuman as she waits for the year-long program, which she hopes will turn her life around.

"It's just something I don't want to do anymore," she said. "I'm so tired of having this addiction. All I want to do is get better."

gareth.hampshire@cbc.ca

@cbcgareth