Kamloops doctor wants other addiction treatments used before heroin compassion clubs

Medical professionals in Kamloops have varying opinions on the practice, along with the idea of injectable opioid agonist treatment (iOAT) — brought about by Kelowna opening an iOAT clinic in April.

Dr. Mandy Manak is the Medical Director of the Interior Chemical Dependency Office, and says while iOAT may benefit a small number of patients, so-called heroin compassion clubs have no role in the treatment of opioid-dependent patients.

“Injectable therapy is for those people who have failed the typical methadone, suboxone route. So it’s an increased intensity of treatment.”

Dr. Manak says the current, non-injectable opioid agonist treatment (OAT) is under-used.

OAT provides addicts with a medication such as suboxone or methadone, which does not get them high, but satiates the craving like heroin or fentanyl would.

“What it does is it stablizes that rewards system in the brain,” Dr. Manak explains, “So you can do the real work of the illness. Which is addressing the mental health issues, maybe anxiety, depression, adverse childhood events, and of course housing.”

The discussion around providing a safe, regulated drug supply comes after nearly 3,000 overdose fatalities in B.C for 2017 and 2018 combined.

Of those deaths, the B.C Coroners Service reported fentanyl was detected in 85 per cent.

“It is a challenge at every level,” Health Minister Adrian Dix explained while in Kamloops Friday, “because a lot of what’s on the street, a lot of what has caused this is effectively poison.”

The B.C government will be carefully studying the BC Centre for Substance Use report, and the idea of heroin compassion clubs in a style similar to what was done with marijuana.

However, even if the decriminalization model countries such as Portugal have implemented was to come to B.C, that doesn’t mean it would produce the same results.

ASK Wellness Kamloops Executive Director Bob Hughes says the cultural differences between European countries and Canada around drug-related stigma are vast.

“I think we can learn from some of the lessons that Europe has undergone,” He explains, “We’ve seen the transition to access to marijuana, and it’s gone smoothly. But that’s a substance that people were comfortable with, and they were open about being able to talk about their use of it.”

People who work to get housing for those struggling with mental health and addictions, like Hughes, agree that considering a heroin compassion club model would be skipping the next step — injectable opioid agonist treatment.

“That hasn’t happened yet in Kamloops,” he explains, “And before we start racing off to put up compassion clubs for people with opioid dependencies, we need to have that figured out first.”

For now, those in Kamloops are turning their attention to smaller, agonist therapy steps before giving decriminalization serious consideration.

“I have lots of patients that come in here and they get on a medication and they can eventually can come off of it. For many people,” Dr. Manak stresses, “And more importantly, go back to work, go back to paying their rent or their mortgage, looking after their kids. And so absolutely it can work.”

by Dylana Milobar

Kamloops doctor wants other addiction treatments used before heroin compassion clubs

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