Detox beds 'harmful' for opiate addiction, specialist says

Dr. Hakique Virani says the province's plan to add more detox beds will not help Alberta's opiate crisis.

Likelihood of overdose increases after detox

Alberta Health Minister Sarah Hoffman, at podium, announces the province's response to the Valuing Mental Health report, the culmination of a mental health review co-chaired by Liberal Leader Dr. David Swann. (CBC)

The provincial government's pledge to open more detox beds will do more harm than good in battling Alberta's opiate crisis, an addictions specialist says. 

On Monday, the government unveiled the results of a mental health review and accepted its 32 recommendations, one of which is boosting the number of addiction treatment beds available in Alberta.

And while detox beds can be helpful in treating alcohol or methamphetamine use disorders, Dr. Hakique Virani said they have the opposite effect for those struggling with opiate dependency. 

"Detox can often have harmful impacts on people who are struggling with opiate use disorder," said Virani, an addiction medicine and public health specialist at the University of Alberta. 

The likelihood of an overdose death increases after detox because a person's tolerance to opiates goes down, Virani explained. 

"It's not an intervention that one would recommend as a first-line treatment for opiate use disorder," he said. "It's really quite concerning that we're not getting it in Alberta."

Harm reduction essential

Virani said he would have liked to see more of an emphasis placed on harm reduction efforts.

"There are some discrete public health interventions that have excellent evidence in terms of reducing the population burden of opiate overdose death," said Virani.

He said safe injection sites could go a long way in reducing harm. 

Virani credited the province's efforts to expand access to naloxone and said that should continue to be a priority. He also acknowledged the work that went into studying how the opiate crisis is impacting First Nations communities. 

Still, he said he's frustrated that the report doesn't have clearer outcomes — one of the six priority actions of the report is to establish an opiate addiction action plan.

"One would hope that after six months of study, the recommendation would be more specific than having a plan," Virani said.