The Alberta government has closed its injectable opioid treatment program to new patients, and people with addictions who are already receiving drug therapy through these facilities have one year to transition out of the effort.
Alberta, under the United Conservative Party, insists this does not mean it is ending the province’s injectable opioid agonist treatment (iOAT) program. Instead, the government argues it extended the previous government’s pilot project by one year and will reconsider future funding after receiving an evaluation report.
The program’s participants are prescribed and inject hydromorphone, a pharmaceutical-grade drug, to manage opioid withdrawal symptoms. Only patients who have unsuccessfully tried oral opioid agonist therapy, where street opioids are replaced with drugs such as suboxone and methadone, are eligible for iOAT. Funding for iOAT’s existing 65 patients ends next March.
This means that unless the government extends funding, the most vulnerable addicts will be left without access to effective treatment and a path to stability, experts argue. The decision was revealed as critics continue to pan an advisory panel’s report on supervised consumption sites, where people can use illicit drugs under the watch of professionals there to prevent overdose deaths, as biased and short on context. The government is skeptical of harm-reduction programs where addicts are permitted to consume drugs.
Rob Tanguay is an addictions psychiatrist and clinical lecturer at the University of Calgary. He said Calgary’s iOAT clinic, which is in the same building as the city’s supervised consumption site, does more than provide a sterile place where people addressing addictions can inject replacement drugs. For example, every person who tested positive for hepatitis received treatment, he said. The clinic, Dr. Tanguay said, has a retention rate of about 80 per cent.
“That is way higher than what we would see in methadone and suboxone,” he said. Further, some patients have been able to “transition down” to suboxone or methadone, he said. This is the type of shift the government hopes will happen as it wraps up funding for iOAT.
People in Calgary’s program visit the clinic three times a day to inject medicine, and have access to professionals such as social workers and psychiatrists. The clinic provides food and some people in the program gained weight, creating an ancillary benefit.
“It creates structure and stability in one’s life,” Dr. Tanguay said. “It improves quality of life and overall functioning.”
Alberta’s initial two-year iOAT program cost about $15-million, said Marshall Smith, the chief of staff for the associate minister of mental health and addictions. The program’s facilities in Edmonton and Calgary have a collective capacity of 80 patients, he noted.
“Our government is awaiting a program evaluation,” Mr. Smith said. The extra year, he said, will allow iOAT’s participants to be “adequately transitioned into other forms of treatment.”
The British Columbia Centre on Substance Use last month released preliminary findings for an iOAT study. Roughly 93 per cent of the 91 people in its study reported a decrease in illicit opioid use while using injectable replacement therapy; 41 per cent accessed other health services while in an iOAT program; and 90 per cent said they did not overdose while participating in the therapy.
Hailey Mawer is a nurse and co-founder of Westside Harm Reduction, a consultancy outfit that favours programs such as iOAT. Ms. Mawer said there is a waiting list for Calgary’s iOAT program and some existing patients believe they will relapse without access to injectable therapy.
“Lots of clients say this is death for them," she said.
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