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Woman suing Alberta government over rules around opioid hydromorphone

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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

A Calgary woman is suing the Alberta government over regulations that would prevent her from obtaining hydromorphone, a potent opioid she takes three times a day to treat her severe opioid use disorder.

Ophelia Black, 21, was diagnosed with the disorder after she developed an opioid dependency as a teen, says the statement of claim filed in Court of King’s Bench on Wednesday.

The document says the treatment regime Black currently follows allows her to effectively manage her condition and prevents her from using street-sourced opioids. But the province’s new standards require service providers to refrain from prescribing opioids for at-home use unless approved by a medical director.

“The regulations are impractical and restrictive for Black, and will result in her no longer accessing the only form of treatment that is effective for her severe opioid use disorder,” says the claim.

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“Black will disengage from treatment and return to street-sourced opioid consumption, increasing her likelihood of overdose death or experiencing other serious health harms related to street-sourced opioid use.”

Black is suing the province under the Charter of Rights and Freedoms to put a halt to the new restrictions and to provide her with an exemption so she can continue to access the treatment as she did previously.

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Her claims have not been tested in court and no statement of defence has been filed.

The province said it is reviewing the statement of claim and couldn’t provide further comment on the case as it is before the courts.

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Black said in a previous interview with The Canadian Press that she tried everything she could to stay sober but continued to relapse, often resulting in an overdose.

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The Community Protection and Opioid Stewardship Standards, established in October, makes it so Black would have to travel to the Opioid Dependency Clinic in Calgary to have hydromorphone administered to her.

The lawsuit says Black currently has a prescription for the drug, which she takes three times a day intravenously at home. As Black doesn’t drive, she would have to travel about six hours per day on public transit to get to the clinic.

The standards include a five-month transition period for health professionals currently prescribing high-potency opioids for addiction.

The statement of claim says Black began using opioids to cope with childhood trauma and that she was regularly sexually, physically, and mentally abused by older men preying on her vulnerable condition. As a result, she began suffering from suicidal ideation, depression and a range of other mental health issues, says the document.

“Opioids provided Black relief from the struggles she endured, but her use resulted in developing a significant dependency,” says the claim.

“Black relied on street-sourced opioids to manage her condition, which resulted in her experiencing numerous overdoses and a variety of other adverse health effects.”

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The province says the risk of these potent opioids getting into the community is too high for them to be administered any other way.

“The service is only for the most severe cases of opioid addiction and is an extremely specialized service,” Colin Aitchison, press secretary to the minister of mental health and addictions, said in a written statement Friday.

“The medications that may be provided as part of this program can be extremely dangerous, especially if they are diverted into the community.”

The province has been working with Alberta Health Services to extend the timeline of the transition or grant exemptions in unique cases, he said.

“We will continue to address these unique situations on a case-by-case basis with AHS.”

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