Made-in-Canada approach to opioid addiction gets nod from prominent medical journal

VANCOUVER — A made-in-Canada approach to treating opioid addiction is garnering positive international attention from one of the world’s most widely circulated medical publications.

The Journal of the American Medical Association has published a review of guidelines developed by a pair of health authorities in British Columbia aimed at educating health-care providers about how best to treat opioid-use disorder.

One of the guidelines’ authors, Dr. Keith Ahamad, says the protocols are the first to provide an evidence-based, gradual approach for how family doctors can best help someone addicted to opioids.

He says they suggest doing away with some traditional strategies that were found to be ineffective or even harmful.

The recommendations include discouraging rapid detoxification as a remedy and encouraging the use of suboxone as a first-line treatment, rather than methadone.

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Suboxone is a mixture of two drugs and has been shown in studies to be six-times safer than methadone, Ahamad says. 

Dr. Evan Wood chaired the committee responsible for developing the guidelines, and says the medical journal’s recognition will hopefully generate interest and focus attention on the need to modernize addictions treatment.

“We spend huge money on the consequences of addiction, but we haven’t traditionally made the investments in a thoughtful approach to the prevention and effective treatment of addiction,” he says.

“Hopefully we’re beginning to turn the corner with that.”

Vancouver Coastal Health and Providence Health released the “Guideline for the Clinical Management of Opioid Addiction” in November 2015, several months before a surge in illicit drug deaths prompted B.C.’s chief doctor to declare a public-health emergency.

Ahamad says he hopes attention from the American Medical Association’s journal will provide both validation and attention to the B.C. guidelines and contribute to their adoption elsewhere.

“Right now the reality is (that) across the country, patients with addiction are bouncing in and out of family doctors’ offices,” he says.

“We need at that moment to give them the treatment that they need that can potentially save their lives, no different than treating blood pressure and diabetes.”

Data from B.C.’s coroners’ service show there were 371 illicit drug overdose deaths in the province in the first half of 2016, a nearly 75-per-cent increase over the same period last year. The deadly opioid fentanyl was detected in more than half of those cases, about a two-fold increase from the previous year.

The Journal of the American Medical Association estimates there are about 2.5 million people in the United States with opioid addiction, and that nearly 29,000 died in 2014 as a result of an opioid overdose.

— Follow @gwomand on Twitter

Geordon Omand, The Canadian Press

Note to readers: This is a corrected story. A previous version said naloxone was the first-line treatment. In fact, suboxone is encouraged as the first-line treatment.