A lack of long-term care for drug overdose victims is hampering B.C.’s fight against the opioid overdose epidemic that claimed 1,400 lives last year alone.
BC Centre on Substance Use director Dr. Evan Wood said that although the national guidelines on addiction treatment released Monday have been piloted in B.C. since July, the province hasn’t implemented them to their full potential.
The problem, Wood told Black Press, is that the majority of the 1,400 people who died of opioid overdose-related causes didn’t receive the evidence-based treatment that could have saved their lives.
Currently, the burden is falling to first responders, and although Wood noted they’ve “done an admirable job,” he said treating the overdose crisis as an acute care issue isn’t solving the problem.
Unfortunately, once paramedics bring their patients to an emergency room, there’s little help for them there and first responders province-wide have expressed frustration that they see the same patients week after week.
“If someone is brought to an emergency room because they’ve been resuscitated from a non-fatal overdose, there’s simply nothing in terms of being able to start the medications, referrals to someone who knows how to treat opioid addiction care. It’s a system that still really needs to be developed,” he said.
LISTEN: Dr. Evan Wood on where addiction treatment is failing patients
At best, the patient is directed to a short-term overdose detox clinic that Wood said can do more harm than good.
“That’s usually a three- to four-day withdrawal off of opioids, and then they’ll be discharged without any further treatment or support,” Wood said.
The new guidelines are pushing for the practice to be nixed.
“Offering withdrawal management as an isolated strategy actually increases fatal overdoses,” he said.
Researchers found that without a long-term system in place, a short-term detox increases the risk of relapse, HIV and hepatitis C transmission and overdose deaths.
“A four-day detox where someone is discharged to the street? You’re better off doing nothing,” Wood said.
He said he’s starting to see shifts from the province on how it’s approaching addiction treatment.
“It’s been so neglected as a discipline in medicine. Most programs are mental health and addiction in name only.”
Conversely, Wood said, the escalating overdose crisis has brought the past inadequacies of B.C.’s opioid-addiction treatment into sharp focus and forced both the province and local health authorities to implement evidence-based treatments.
Wood blames the ‘war on drugs’ approach for pushing funding away from the healthcare system and towards the legal system.
“When you criminalize a disease and have a total criminal justice approach to a health issue, that makes it very difficult to address stigma,” said Wood.
“It’s reckoning time right now in Canada to look at all the unintended consequences of the war on drugs.”
Wood said he would like a study on how Portugal’s decriminalization of drugs could be applied in B.C.
In the early 2000s, Portugal, which had some of the highest overdose rates in the European Union, largely decriminalized drugs.
Wood said that treating addiction as a health issue instead of a criminal one has seen Portugal’s overdose rates become some of the lowest in the region, to the point that the country has backed away from supervised injection facilities because there aren’t enough people using intravenous drugs.