B.C. centre on substance use releases guidelines for treatment of opioid abuse

B.C. centre releases opioid treatment guidelines

VANCOUVER — British Columbia’s fledgling network for research into drug abuse has released new provincial guidelines for doctors and nurses on treating people addicted to opioids.

The move marks a shift away from the College of Physicians and Surgeons of B.C. as the body responsible for developing provincewide treatment protocols related to the overdose crisis, which claimed more than 900 lives in the province last year.

College spokeswoman Susan Prins said the transition is expected to free up resources and allow the regulator to conduct “enhanced monitoring” of all prescriptions that pose a risk to patient safety, not just methadone.

“The college has run a methadone-maintenance program for several years now, which has included authorizing exemptions to physicians who wish to prescribe methadone for opioid-use disorder … running educational programs and developing guidelines, which isn’t a typical role for the regulator,” Prins said in an email on Tuesday.

By June 5, the new guidelines developed by the B.C. Centre for Substance Use will replace those previously established by the college.

The updated protocols discourage solitary withdrawal treatment and recommend buprenorphine and naloxone as first-line medications, relegating methadone to the role of a backup if alternative treatments are ineffective. The guidelines also propose tapering treatments to lower-intensity doses, as well as the option of take-home dosing.

The centre’s inaugural director, Dr. Evan Wood, and Health Minister Terry Lake revealed the new guidelines at a news conference that announced $5 million of endowment funding from the province for the research network, along with $1.9 million per year in additional ongoing support.

The B.C. Centre on Substance Use is a provincial network of health-care workers and researchers tasked with expanding care for people who suffer from substance-abuse issues. It is scheduled to become fully operational at the beginning of April.

Wood said two of the centre’s main areas of focus will be clinical studies examining the efficacy of slow-release oral morphine, and research into offering better support for people in recovery so that patients are not simply treated then discharged into the community without help or followup.

In September, Premier Christy Clark pledged $5 million toward the creation of the centre, which will include representation from First Nations, people who use drugs and all health authorities.

On Tuesday, Lake described the overdose epidemic as the worst public-health emergency Canada has ever seen.

“It would be terrible to squander this crisis and not develop a better system of treatment, prevention and prescribing for opioid-use disorders.

“Nobody wakes up in the morning and says I’d like to be a drug addict. This is a path that people find themselves on for many complex reasons,” Lake said, adding that more work is needed to remove the stigma from addiction.

Lake also responded to recent calls for provincial funding for non-opioid alternatives to pain management, especially chronic pain, which would encompass treatments ranging from physiotherapy to cognitive behavioural therapy.

“I don’t want to make a policy announcement here, but I think we need to look and see where the evidence leads us and where there is a good argument for people that have been diagnosed with chronic pain that we look for those alternatives and we look for ways of supporting them,” he said.

— Follow @gwomand on Twitter

Geordon Omand, The Canadian Press

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