Alberta government to end funding for intensive opioid therapy program

The Alberta government is asking doctors to transition dozens of people with severe opioid addictions off an injectable treatment program intended to save lives when other therapies prove ineffective.

'That is a very, very heartless message and that’s not how we do things here in Alberta'

B.C. has been at the forefront of Canada's opioid overdose crisis and health professionals say providing more treatment options will save lives. (Darryl Dyck/Canadian Press)

The Alberta government plans to cut funding for an opioid treatment program offered as a last resort to people with severe addictions when other therapies are ineffective.

The government says 65 people on injectable opioid agonist treatment (iOAT), a two-year pilot program, will be transferred to other health services before funding for the program ends on March 31, 2021. 

A spokesperson said there are no plans to fund the program past next March. 

Critics maligned the government's decision, saying it endangers clients on iOAT. 

"I'm heartbroken over this and I don't understand how the government can cut a program that is effective and has helped people to find stability and health in their life and deal with their substance use issues," said Petra Schulz, Edmonton-based co-founder of national harm-reduction advocacy group Moms Stop the Harm. 

Doctors only refer a client to the iOAT program when other treatments fail, according to Alberta Health Services background documents.

Clients inject hydromorphone three times a day under the supervision of a nurse, who adjusts the dose based on the response. 

An attack on most vulnerable: Opposition critic

People with chronic opioid dependency may find methadone treatment is ineffective. Some report their cravings persist and others simply can't reach a therapeutic dose with an oral-based therapy, according to the Canadian Research Initiative in Substance Misuse. 

"This is literally attacking the most vulnerable individuals at a time when they are finally being given stability," said NDP MLA Heather Sweet, the Opposition critic for mental health and addictions. 

A two-year pilot program was announced by the previous NDP government at the end of 2017, at a time when an average of more than two people were dying from opioid overdoses every day.

The latest AHS statistics show overdose deaths are at the lowest levels in more than three years — 120 people over three months — a development harm reduction advocates credit to the introduction of supervised consumption sites and programs like iOAT. 

This is literally attacking the most vulnerable individuals at a time when they are finally being given stability.- NDP MLA Heather Sweet, opposition critic for mental health and addictions

AHS treatment centres in Edmonton and Calgary introduced iOAT by early 2019, making Alberta the second province after British Columbia to offer the treatment. 

Research shows iOAT cuts rates of illicit opioid use, treatment drop-out, criminal activity, incarceration and death among clients who resisted methadone treatment, according to a review by the Canadian Research Initiative in Substance Misuse

A $14-million grant for the program was set to expire at the end of this month, but a government spokesperson said it was renewed for another year to transition patients into other forms of treatment. 

"Patients will be transitioned to the health services that are most appropriate for their needs, determined by medical professionals," said Kassandra Kitz, press secretary for Jason Luan, associate minister of mental health and addictions. 

'Very heartless message' 

In the face of the opioid crisis, advocates say the program keeps clients with the most severe addictions off a dangerous opioid street supply and out of illicit drug trafficking markets, while connecting them with other support services such as counselling. 

Schulz said she learned about the government's decision on Friday, one day after the Supervised Consumption Services Review Committee publicly released its findings.

The panel — made up, in part, of police officers, an economics professor and health-care professionals with a history of support for abstinence-based treatment — was tasked with studying the social and economic impacts of supervised consumption sites in Alberta.

The review did not consider the merits of harm reduction or the impact to housing and homelessness after the government placed those topics outside the panel's mandate. 

A spokesperson for associate minister of mental health and addictions Jason Luan said patients on iOAT will be transitioned to other programs by March 2021. (Trevor Wilson/CBC)

Upon seeing the preliminary report in January, Premier Jason Kenney said it underscored the negative impact the consumption sites were having on communities around some drug injection sites, calling them illegal drug sites.

Staff at the province's seven consumption sites have tended to more than 4,000 overdoses since doors opened in 2018 and no client has died, according to AHS statistics. 

Sweet said the decision to end the iOAT program is an example of the government's hostility toward harm reduction, and suggested it could be a harbinger for future cuts to treatment. 

"This is just an ideological decision being made by this government that is ultimately going to hurt individuals with addictions," Sweet said. "It's the medical professionals that should be making these decisions."

Kitz, the associate ministry spokesperson, said the program was always intended to be a pilot and the previous government had no transition plan for clients past the two-year mark.

There was no transition plan because there was no plan to end funding, Sweet said. 

Given other treatment options have proven ineffective for clients referred to iOAT, Schulz is concerned some will turn to street drugs again at the risk of arrest or death. 

"To a person in iOAT, it says, to me, this province doesn't care if you live or die. If you don't fit into our ideology, you're not worth saving. And that is a very, very heartless message and that's not how we do things here in Alberta," Schulz said.