B.C.’s new protocols for opioid abuse treatment garner some criticism

published on February 7, 2017 by ANDREA WOO and JUSTIN GIOVANNETTI in The Globe and Mail

Drug users and harm-reduction advocates are calling British Columbia’s revamping of its clinical guidelines for treating opioid dependency a missed opportunity to expand heroin-assisted treatment – a controversial option has garnered support from the federal government amid the province’s worst overdose crisis on record.

The release of the province’s new guidelines on Tuesday – which take effect in June – came at the same time that health officials in Alberta announced a 25-per-cent increase in fentanyl-related deaths over the past year. New figures show that a record 343 people died of fentanyl-related overdoses in 2016, compared with 257 in 2015. (Alberta’s total illicit-drug overdoses for 2016 are not yet available.)

“Opioid overdoses and deaths are a public-health crisis in Alberta,” said Alberta associate Health Minister Brandy Payne. “Everyone in this room knows the devastating impact fentanyl and other opioids are having on families and communities.”

B.C.’s new guidelines, created by the recently formed B.C. Centre on Substance Use (BCCSU), place an emphasis on providing a broad range of options tailored to individual needs. The comprehensive document will replace existing guidelines by the College of Physicians and Surgeons of B.C. on prescribing the opioid-replacement therapies methadone and Suboxone – the trade name for buprenorphine-naloxone – in June.

While the guidelines include a new tool – slow-release oral morphine – to the existing treatment options, some say they missed the opportunity to widen the availability of Supervised Injectable Opioid Assisted Treatment (siOAT).