Methadone numbers a sign of awareness, not more addicts
By Gillian Slade on August 18, 2018.
gslade@medicinehatnews.com @MHNGillianSlade Alberta Health Services says dispensing more methadone than other parts of Alberta does not mean the south zone has more addicts, but that more people are aware of the alternatives. “Especially in southern Alberta where we have historically … seen periods of very high rates of opioid deaths, the public awareness may lead to more people seeking treatment,” said Dr. Nick Mitchell, Alberta’s provincial medical director of addiction and mental health. In 2017/18, the dispensing of drugs such as methadone and suboxone in the south zone, including Medicine Hat and Lethbridge, was 106 per cent higher than the provincial average, according to the Alberta Health Opioids and Substances of Misuse report for the first quarter of 2018. This trend is exactly what AHS is hoping to see across the province, said Mitchell. Methadone is a long-acting opioid for those who have developed “toleration dependence on opioids,” said Mitchell. It can last 24 to 36 hours and can prevent them from going into withdrawal, which can include a lot of physical pain, diarrhea, nausea and dehydration. Methadone also prevents the cravings to use drugs. “Because it is used in a supervised way it is safer than those individuals taking non-prescribed opioids,” said Mitchell. In Medicine Hat there are two methadone and suboxone opioid addiction clinic pharmacies, on Maple Avenue and Fourth Street SE, according to online information. The choice between methadone or suboxone depends on other medical conditions and the person’s history of success in trying to address the addiction. Methadone would initially be taken in the presence of a dispensing pharmacy. Later they may be given doses to take at home. Suboxone is easier to use but more expensive, said Mitchell. The drugs are not free but there are a range of programs such as the Alberta drug benefit, AISH, or seniors benefit to cover costs, said Mitchell. Some are covered by private insurance companies. There is the potential for someone to overdose if they are on methadone and also take another opioid. “It could happen with suboxone but is less likely,” said Mitchell. Suboxone is a “partial agonist” that blocks the receptor that opioids might be working on, he explained. Mitchell did not have data on how many people in Medicine Hat are currently on methadone or suboxone. A triplicate prescription is required for them so that data is kept by the Alberta College of Physicians and Surgeons. The News requested that information but it was not provided in time to be included in this story. Both drugs are for the long-term but one year would be considered the minimum. Some stay on them for years, said Mitchell. Generally the research has shown the longer they stay on the medication the greater the chance of long-term success. To stop taking the drug they are slowly tapered off under supervision to prevent withdrawal and the likelihood of relapse. In helping someone overcome their addiction it is their goals that become the focus rather than just stopping the use of a substance, said Mitchell. Other issues in the person’s life have to be taken into consideration such as poverty, homelessness and social support. For some it is possible to completely abstain but for others that is not the goal, he explained. “What we’re really trying to do is reduce the opioid harm. In that context it is less important to make sure they abstain and more important to reduce the likelihood of overdose,” said Mitchell. The number of emergency room visits and hospitalizations related to opioid use is also 25 per cent and 26 per cent, respectively, higher in the south zone compared to the rest of the province, according to the report. One possible reason for these higher numbers could be contaminated drugs in the community at the time, said Mitchell. 23
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