Making health care work for opioid users

Mar 22, 2022

In a recent article published by Faculty of Medicine at the University of British Columbia (UBC), Dr. Seonaid Nolan and Dr. Julia Zazoulina discussed ways to provide better care for individuals affected by opioid use disorder.

In 2021, British Columbia reported record numbers of drug overdose-related deaths, while addiction and health experts have been advocating for more effective treatment approaches.

“Untreated opioid use disorder is a public health emergency — compounded by the toxic drug supply in Canada. Unfortunately, resources for evidence-based solutions have been scarce,” said Dr. Nadia Fairbairn, professor in Addiction Medicine and lead author of the first national injectable opioid agonist treatment guidelines.

Together with colleagues at UBC and the B.C. Centre on Substance Use (BCCSU), Dr. Fairbairn has been urging the government to make the health care system “more responsive” to treat addiction issues by using a combination of innovative treatment approaches including injectable opioid agonist treatment (iOAT), harm reduction initiatives, addiction medicine training for healthcare professionals, and research.

However, there are currently no existing comprehensive, real-world models for tackling the ongoing overdose crisis. According to research studies, for individuals with severe opioid use disorder, gaining access to prescribed substances under the care of health care professionals can be both life-saving and life-changing. Despite this, such access has been limited due to a lack of prescribers.

“One of the greatest barriers to access for iOAT is training,” says Dr. Fairbairn. “We recognized that many clinicians and healthcare providers wanted to help, but they felt like they didn’t know where to start.”

The data shows that iOAT reduces overdose risk, increases patients’ likelihood of addiction recovery, and has a positive impact on their overall health.

“Programs like iOAT act as a mechanism to engage patients in the health care system generally, creating opportunities to provide treatment and support earlier on,” said Dr. Seonaid Nolan, UBC professor in Addiction Care Innovation and a clinician-scientist at the BCCSU.

“It’s important to recognize that many people with severe OUD only present to the ER when they have severe complications, like infected joints or heart valves,” added Dr. Nolan.

Currently, Dr. Fairbairn and her colleagues are carrying out an in-depth study of patient experiences in iOAT programs. They hope that the results of this research could lead to significant changes across existing treatment programs, to improve their effectiveness and create future ones.

Furthermore, the number of iOAT programs across Canada has increased from 11 to 15 over the past three years, although Dr. Fairbairn has pointed out that access has remained limited and more resources are needed to meet demand.

“We need to continue to scale up. We need to close the gap between evidence and practice. Lives depend on it. When we make health care work for people with substance use disorders, we create new space and time for them to begin a journey of healing, to build relationships, set goals, and ultimately, think about the future.”