In the first six months 2023, 6,211 people in Alberta received opioid substitution therapy, doubling the number of people who accessed this addiction treatment in 2018.
It’s an attempt to deal with a drug-poisoning crisis that that killed a record number of Albertans last year that experts say will lead to more deaths this year.
“The truth of the matter is, it is an epidemic. It’s killing people at a rate that we just never fathomed possible,” said David Lewry, the executive director and addictions counsellor at Freedom’s Path Recovery Society in Calgary.
Albertans are increasingly dying of opioid drug poisoning. In 2016, 554 Albertans lost their lives. In 2023, the number of deaths climbed to 1,411 people within eight months, according to Alberta’s substance use surveillance data.
Opioid treatment in Alberta
According to the Government of Canada, opioid substitution therapy is designed to take the severity and pain out of opioid withdrawal through the use of medication.
Smart Clinic, a medical office located in Calgary, takes a holistic approach by providing both mental health care and addiction services. The clinic’s treatment programs for opiates offer either methadone or suboxone as medications for opioid substitution therapy. People struggling with opioid addiction are welcome to walk-in for a consultation.
“Once they are taking opiates and they are taking them for a prolonged time, they start building tolerance and then withdrawals and cravings,” said Ravneet Sidhu, a registered nurse and clinic manager at Smart Clinic. “And when they are not getting that same comfort, symptoms and relief with the amount they’re using, then they realize that something is wrong.”
Before beginning treatment, patients are required to fill out a detailed medical history and answer personal questions about their life so the doctor can determine exactly what resources are necessary. A physician will then work closely with the patient to determine if methadone or suboxone is a better fit for the patient.
Methadone is prescribed as a liquid and cuts cravings and withdrawals, inhibiting the ability to make the patient feel high. This substance must be taken in front of a medical professional.
“Methadone is a very old-school medication. Still works. Still better than not taking any medication,” said Sidhu. “With methadone, if they take any other substance on top of it, it still works. They can still feel euphoric, they can still feel high.”
“In my experience over a decade, I never saw anyone who weaned off from really hardcore opiates by themselves and never used it again.”
Ravneet Sidhu
The second choice is suboxone. Prescribed as a tablet or film that is meant to dissolve under the patient’s tongue, this medication can be prescribed in take-home doses once the doctor finds the appropriate dosage for the individual.
“Suboxone is much safer and it actually helps to prevent overdoses,” said Sidhu. But adds, “With suboxone they cannot use [opiates] because suboxone covers the receptor in such a way that if they use any opiates, it does not work.”
Smart Clinic does not provide a time frame for an individual to end opioid substitution therapy. It is entirely up to the patient when they want to stop. However, Sidhu said without the use of methadone or suboxone as a treatment, self-weaning off opioids will only work for a short time.
A complex problem
Lewry, the addictions counsellor, has seen the devastating impact of unsupported addiction first hand. He said this sort of treatment should be as simple and accessible as possible and go hand-in-hand with mental health supports.
“A hard thing that we don’t talk about in connection with opioids or drug use of any kind, is the connection or the correlation between the drug use and treating a mental illness that might be undiagnosed.”
On their website, the Government of Alberta says it has designed an approach that includes treatment and recovery:
“Opioid addiction is a complex issue that requires a comprehensive and holistic approach, including prevention, intervention, treatment and recovery. We are working with partners to inform Albertans of the wide range of addiction services available so they can access the recovery services that best suit their needs.”
Alberta Health Services (AHS) offers specialized programs for detox, opioid substitution therapy and narcotic transition services to assist people who wrestle with substance abuse and addictions into treatment. Alberta also provides supervised consumption sites through AHS in Calgary, Edmonton, Red Deer, Lethbridge and Grande Prairie.
While various treatment programs exist, Lewry notes the many layers and complexity involved with rehabilitation. He said any suggestion there is a single treatment for an addiction is when we actually lose track of all the other addicts who are not compatible with that one solution.
“Once we sober up, we stop the chemical, and then we’re all the same, but we’re not. And that, I think, is one of the big limitations of some of these set programs.”