Opioid-dependent patients worry changes to Alberta’s prescription methods will be harmful

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Opioid-dependent patients worry changes to Alberta’s prescription methods will be harmful
WATCH: A new provincial government strategy intended to fight addiction could backfire, according to patients and physicians. The Alberta plan takes effect at the end of October and harm reduction advocates say the changes could cause people to be more at risk for opioid poisoning. Jill Croteau explains – Oct 17, 2022

The province’s new proposed plan to restrict where people can consume prescription narcotics — many of which are lifesaving for former and recovering addicts — has one Calgary woman concerned about her health and the future of opioid recovery.

Ophelia Black said she fears the worst if the provincial government follows through with their changes to the way opioids are prescribed.

She said she struggled with mental illness early on in life.

“For the first 19 years of my life, I didn’t know what happiness felt like. I didn’t plan to live to 18,” Black said.

“I ended up having a nervous breakdown and went to the hospital and they gave me pain killers,” Black said.

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She eventually turned to fentanyl. Her mom, Marianna Balogh, said watching her daughter in her addiction was heartbreaking.

Marianna Balogh. Jill Croteau/Global News

“I was walking up to her door to listen if she was still alive or not. I was expecting her to die — I was in constant fear,” Balogh said.

As part of her treatment, Black was prescribed a hydromorphone, which she said saved her life.

Ophelia Black. Jill Croteau/Global News

“This was a last resort. I have tried classic anti-depressants and suboxone — none of that worked and I am so lucky this worked as well as it did,” Black said.

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But the ease of getting that medicine that is keeping her stable is about to get more complex. The province’s new plan is intended to ensure people can’t trade or sell their narcotics. The establishment of the Narcotic Transition Service will mean certain opioids will soon only be administered in a supervised setting.

Black said it’s restricting access for her others who have to travel to one of 11 clinics across the province. The only one within Calgary is located downtown. She would have to take transit three times a day and it would be two hours round-trip, three times a day.

“I take three doses every day. Some people take them every hour. It’s going to make it impossible for me to access my medication,” Black said. “The clinic isn’t open for two of my three doses,” Black said.

Eric Engler, Press Secretary for the Mental Health and Addiction Minister, Mike Ellis, said the changes will protect the community from the diversion of dangerous opioids.

A person injects hydromorphone. File THE CANADIAN PRESS/Darryl Dyck

“The risk of these drugs being diverted is simply too high to offer this service in any other way,” Engler said in a statement to Global News.

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According to the province, the Community Protection and Opioid Stewardship Standards are based on learnings from the ongoing opioid addiction crisis and the best available evidence from around the world.

The new rules also require a treatment plan for patients, with the expectation to transition them to what are considered lower-risk opioid agonist therapy (OAT) medications.

“The vast majority of Albertans with opioid addiction are able to successfully stabilize and enter recovery with evidence-based OAT medications like suboxone, sublocade and methadone,” Engler said.

“I need that prescription as the foundation because I’ve fallen in love with life and I want to live a long happy health life,” Black said. “I am so careful and consistent how I am taking it.”

She uses NORS, an overdose prevention hotline where Canadians get virtual support and supervision. She is worried about the impact without the ease of being able to take her at-home medication.

“I am terrified. What I am going to have to do if I don’t have access to this medication? What will I do to fill that gap? What if I go back on fentanyl?” Black said.

“I want to go back to school and pay off my debts and be stable.”

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Her mom said she also doesn’t want her daughter to stumble backwards.

“Where do you draw the line of who gets safe medication and who doesn’t? If you have mental health issues you don’t have the right to your medication. And if you die, you’re just a casualty. It’s not right,” Balogh said.

“I would do anything to keep her alive and this medication is keeping her alive,” Balogh said.

Patty Wilson is the president of the Alberta Nurses Coalition for Harm Reduction (ANCHR) and is pleading with the province to reconsider the plan. ANCHR has sent an open letter to the provincial government.

Opioids. AP Photo/Keith Srakocic, File

“The government keeps talking this narrative that we are in the middle of an addiction crisis. We are in the middle of a poisoning crisis,” Wilson said.

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She said people need hydromorphone to keep them from returning back to street fentanyl, which is more toxic and more dangerous.

“Short-acting opioids are trying to replace fentanyl. People are able to be well because they aren’t consuming poison — they are consuming pharmaceutical-grade opioids,” Wilson said.

“This new program is will force people to transform their life, any semblance for normalcy is gone. It’s not sustainable,” Wilson said. “If the government cared about diversion then they would fund housing programs and increase AISH (Assured Income for the Severely Handicapped).”

Black hopes she’s granted an exception once the program takes effect on Oct. 31.

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