Opioid Addiction Guidelines from British Columbia featured in leading medical journal

published on July 19, 2016

Vancouver, BC [July 19, 2016] A novel approach to treating opioid addiction in British Columbia is attracting major international attention after being reviewed and featured in the prestigious Journal of the American Medical Association (JAMA). A Guideline for the Clinical Management of Opioid Addiction, a first-of-its-kind in Canada, aims to improve health professionals’ knowledge of the range of evidence-based treatments available for opioid addiction, one of the most challenging forms of addiction facing the health care system today. Untreated opioid addiction is a major driver of the recent surge in illicit drug overdose deaths, which prompted B.C.’s Provincial Health Officer, Dr. Perry Kendall, to declare a public health emergency earlier this year.

In the absence of evidence-based recommendations, dangerous practices like offering medical detoxification as an isolated strategy have been common for many years whereas methadone has been the primary first line medication for treating opioid addiction. With support from the Province of British Columbia, the guidelines were developed to articulate the diversity of possible treatment options that can be staged and tailored to individual patient needs. The guideline’s unique suggestions include recommending buprenorphine/naloxone (Trade name Suboxone®), as the preferred first-line treatment for opioid addiction. According to research summarized in the guideline, Suboxone® is six times safer than methadone in terms of overdose risk and permits more flexible “take home” rather than pharmacy dosing. The guidelines support using a stepped and integrated care approach, where treatment intensity is continually adjusted to match individual patient needs and circumstances over time, and recognize many individuals may benefit from the ability to move between treatments.

“By incorporating principles of evidence-based medicine into addiction care, the province has the potential to realize a dramatic reduction in the public health and community concerns arising from untreated addiction,” said Dr. Evan Wood, guideline committee chair and Professor of Medicine at the University of British Columbia, Medical Director of Addiction Services at Vancouver Coastal Health and Providence Health Care, and Director of the Urban Health Research Initiative at the BC Centre for Excellence in HIV/AIDS.

In August 2014, Health Minister Terry Lake announced an initial $3 million investment to support Dr. Wood’s research, education and clinical care guidance program in an effort to harness new ways to treat addiction and related health concerns. The guidelines are one example of the foundational work made possible through this partnership.

“It is great to see our investments in improving the addiction system of care are generating international recognition and, given the seriousness of the opioid overdose crisis, there is an urgent need to expand this work provincially and move on recent changes that have been made to improve access to evidence-based treatment,” said B.C. Health Minister, Terry Lake.

Most recently, in order to expand patient access to opioid addiction treatment in the province, the College of Physicians and Surgeons of B.C. lifted restrictions on prescribing Suboxone®. This regulatory change has been recommended by health researchers in the Canadian Research Initiative in Substance Misuse (CRISM), who issued a report calling for improved access to evidence-based treatment for opioid addiction as a strategy to address the provincial overdose crisis. Credited with an 80 per cent reduction in fatal opioid overdoses in France, Suboxone® can now be prescribed by primary care and generalist physicians in B.C.

“I’m pleased to see the province’s approach to addiction is moving towards one where care providers can be guided by the best available evidence for the prevention and treatment of addiction,” said Leslie McBain, community advocate and founding member of Moms Stop the Harm, whose son Jordan died of a prescription drug overdose. “If these new policies and expert guidelines were available provincially when my son was struggling with addiction, we may have been successful in our efforts to identify a physician who could provide life-saving treatment.”

The opioid addiction treatment guidelines were developed by an interdisciplinary committee comprised of individuals from Vancouver Coastal Health, Providence Health Care and representatives from the B.C. Ministry of Health. The guidelines were subsequently peer-reviewed by patient and family groups as well as local and international experts in the field. Authors of the opioid addiction treatment guidelines have partnered with the BC Association for People on Methadone to disseminate the guidelines and information to public and private clinics around the Lower Mainland, with additional outreach efforts underway in other B.C. health authorities.


About the Canadian Research Initiative on Substance Misuse
The CIHR Canadian Research Initiative on Substance Misuse (CRISM), is a national interdisciplinary research consortium comprised of four regional Nodes (BC, Prairies, Ontario, Quebec/Maritimes), uniquely focused on cross-cutting translational and implementation addiction research in the area of addiction clinical trials. The BC Node of CRISM, led by Principal Investigator Dr. Evan Wood, is an expert network of over 50 contributing members, including knowledge users, service providers, community members, and research scientists, affiliated with the BC Centre for Excellence in HIV/AIDS, the University of British Columbia, and Simon Fraser University, among others. Through its work, the CRISM nodes are firmly committed to working with communities to ensure translation of scientific evidence into practice and policy change, promoting evidence-based approaches to addiction treatment, and training the next generation of leaders through our comprehensive education programs.

About the Urban Health Research Initiative
The Urban Health Research Initiative (UHRI) is an innovative research program of the BC Centre for Excellence in HIV/AIDS based on a network of studies developed to help identify and understand the many factors that affect the health of urban populations. Focusing primarily on issues relating to problematic substance use, infectious diseases, the urban environment and homelessness, UHRI aims to improve the health of individuals and communities through research to inform policy. Founded in 2007, UHRI’s team consists of researchers, epidemiologists, statisticians, ethnographers, research assistants, research coordinators, registered nurses, knowledge translations coordinators, students, and support staff.

About the British Columbia Centre for Excellence in HIV/AIDS
The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada’s largest HIV/AIDS research, treatment and education facility and is internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. BC-CfE is based at St. Paul’s Hospital, Providence Health Care, a teaching hospital of the University of British Columbia. The BC-CfE works in close collaboration with key provincial stakeholders, including government, health authorities, health care providers, academics from other institutions, and the community to decrease the health burden of HIV and AIDS. By developing, monitoring and disseminating comprehensive research and treatment programs for HIV and related illnesses, the BC-CfE helps improve the health of British Columbians.

For additional information or to request interviews, please contact:
Diane Pépin, Communications Coordinator, BC-CfE
Email: [email protected]