Canada’s treatment of fentanyl, opioid addicts hazardous and outdated, says physician

published on February 28, 2017 by Bill Kaufmann in Calgary Herald

Canada’s use of methadone to treat fentanyl and other opioid abuse is dangerous and outdated, says a substance-abuse expert gathered with others in Banff mapping out addiction strategies.

Canada should follow other countries, including the U.S., that have moved toward using another drug, buprenorphine/naloxone to manage opioid addiction, said Dr. Cam Wild of the School of Public Health at the University of Alberta.

“Canada has fallen behind other countries in treatment “” in many places, Suboxone is the first line of care,” said Wild, using buprenorphine/naloxone’s brand name.

Suboxone, he said, has proven much less lethal than methadone in jurisdictions where it’s been publicly used.

“It has much less ability to kill people . . . so we can convince the approval and treatment systems to update,” said Wild, who chaired the meeting of about 40 experts in Banff.

Also risky is the too-commonly-used approach of cold turkey in ending individual addictions, he said.

“One of the most dangerous things is to do a rapid detox but, unfortunately, it’s the standard in many scenarios,” said Wild.

The comments came amid an accelerating death toll from the use of synthetic opioid fentanyl, which killed 343 people in Alberta last year, a third of them in the final quarter of 2016.

Wild called it an emergency but said the province’s refusal to declare it one is less important than the work it seems to be doing in combating the scourge.

“This is a major public health problem, and the government and Alberta Health Services are taking steps now to address this,” he said.

But one of the reasons Canada has fallen behind is due to the longtime lack of a national network to tackle drug misuse issues.

Two years ago, the Canadian Research Initiative in Substance Misuse (CRISM) was created to do just that and is preparing to launch a nationwide study comparing the merits of methadone and Suboxone.

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