Fentanyl addicts need more streamlined services

The head of mental health and addictions services for Alberta says the province needs to improve access to drugs that combat addictions to opiates like fentanyl, because abstinence doesn't work.

Head of addictions services says addicts need better access to anti-opiate drugs

From left to right: Receptionist Sharon Curly Rider, Dr. Susan Christenson and nurse Donna Grosventreboy all work at the Levern Health Clinic on the Blood Tribe reserve. Christenson recently received a special license to prescribe the opiate replacement drug Suboxone. (Judy Aldous/CBC)

The head of mental health and addictions services for Alberta says the province needs to do more to help the growing number of people addicted to the street drug fentanyl, which is 100 times more potent than morphine.

Dr. Michael Trew says the surge in overdose deaths (six in 2011, 120 in 2014 and 50 in the first two months of 2015) "took us all by surprise." Trew says the biggest challenge is that there aren't enough physicians able to prescribe the drugs used to treat opiate addicts.

"The preferred treatment for fentanyl and any other opiate addiction is actually replacement treatment and we have two drugs. One is methadone and the other is Suboxone."

Trew says unlike with alcohol addiction, abstinence from opiates doesn't work because "relapse comes with substantially increased risk of overdose."

Too few licensed doctors

But Trew says one of the biggest challenges is getting physicians trained to provide these drugs. "These are not drugs that every physician can prescribe. For methadone, you have to go through a course, you have to work with another doctor. It costs you time and some money and it's not what most doctors have planned to do as part of their medical career."

Trew says the process for treating people addicted to opiates is so labour intensive that most doctors don't make money doing it.

He says the physicians need to be better supported. And client services also need to be streamlined.

"We've ended up asking people, when they're probably at their worst, to go here for this and there for something else. That probably isn't the best way to help people. Now pulling those pieces together is not simple but those are some of the discussions we're having."

Working on the Blood Reserve

One physician who made the effort to get a license to prescribe the drug Suboxone is Dr. Susan Christenson of the Levern Health Clinic on the Blood Tribe Reserve, west of Lethbridge.

"I want a tool to help people with this addiction. There's nothing we as physicians can offer that works and this seems to work. It seems to really help people and give them their lives back."

Her reserve has been hit hard by fentanyl abuse; about 20 people have died from overdoses since last summer. Three weeks after receiving her special license, Christenson said she was accepting three to four new patients with opiate addictions every week, with a wait list of over two weeks.

Preventing death by overdose

The province is spending $300,000 to improve access to the anti-overdose drug naloxone.If injected soon after an overdose, naloxone can reverse its effects buying the addict time to make it to a hospital.
Example of take home Naloxone kit that Streetworks in Edmonton distributes to opiate addicts, to prevent overdose deaths. (Streetworks Edmonton)

The plan is to have naloxone kits available to those addicted to opiates and their friends. The program is modelled after one based in Edmonton, run by the agency Streetworks.

Marliss Taylor is the program manager with Streetworks. "We've been doing this program since 2005. We are helping our community members who are using opiates get a kit that can help save their lives and the lives of the people around them."

She says they have trained 200 people to recognize the signs of an overdose and administer naloxone.

The Central Alberta AIDS Network Society in Red Deer is also distributing naloxone kits.