As fenatnyl continues to claim lives, B.C. has shifted away from the use of methadone as the primary opioid treatment and towards a drug called suboxone.
“It alleviates opiate withdrawal initially and then also helps with cravings for opiates such that when we dose it appropriately, people don’t have cravings at all,” Interior Health’s medical lead for addiction medicine Dr. Leslie Lappalaine said.
“It’s about six times safer (than methadone) in terms of overdose risk.”
As of February 1, suboxone became covered by B.C.’s PharmaCare program but some addicts are still struggling to get a prescription for the lifesaving drug; that’s because physicians need special training in order to prescribe it, meaning patients have to wait.
“We are trying to make it as accessible as we can for everyone,” chief medical health officer Dr. Trevor Corneil said.
“We have…improved our wait times in Kelowna quite significantly from six months to two-to-four weeks, depending on the week, and we’re really pushing to push that down to zero.”
Interior Health doesn’t have hard-and-fast numbers on how many people have been prescribed suboxone since the fentanyl crisis began, but Dr. Lappalaine said “we are having trouble keeping up with demand.”
Pharmacists are on the front line of subxone treatment, as when its first prescribed patients must take their dose at the pharmacy, to ensure they take the medication properly.
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“Quite often they’re here almost every day over a certain period of time through the course of their treatment,” London Drugs pharmacy manager Zach Stevens said. “The treatment allows us to develop that relationship and trust with the patients themselves.”
Doctors say suboxone not only saves, but changes lives.
“When they’re on the right dose they aren’t using opiates. They can have life back, go back to school, back to work, maintain relationships with family, avoid doing crimes; which a lot of patients do to support drug use,” Dr. Lappalaine said.
Why detox doesn’t work
Drug detox is commonly used as a way to get addicts to kick the habit, but for those addicted to opioids, it may not be the best choice, at least on its own.
“The research is quite clear that going to a detox centre for rapid in-patient detox, over the course of five to seven days, without a longer-term plan for either intensive treatment or to be put on medications like methadone or suboxone as a maintenance therapy, really isn’t effective,” Dr. Lappalaine said.
“The relapse rates are very high, upwards of 90 per cent.”
The other danger is if, more likely when, a relapse occurs, addicts will have lost their tolerance to opioids, making the risk of that slip more likely to turn into a fatal overdose.
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