Opioid overdose deaths may dominate the news but Island Health says it is finding success with its rapid access addiction clinic for opioid withdrawal.
The Pembroke Street clinic helps people to safely withdraw from opioids, prescribing medications like suboxone and methadone to reduce cravings, says addiction medicine specialist Dr. Caroline Ferris.
The clinic sees a range of people, from the employed and high-functioning to street homeless and everything in between, says Ferris, Island Health’s regional medical director for addiction medicine. “And there are no waits.”
When people check in, they will be seen by a nurse or a counsellor.
“Three staff can do the intake, so people don’t wait,” she says. “They show up at our door and our priority it to get them into the room and get things started.”
Patients are expected to give a urine sample, which is tested on site. The sample lets doctors and nurses know what drugs the person is using and affects the type of medication they prescribe, says Ferris. The doctor sees the patient and lets the patient know their medication options.
Patients are given a requisition for blood tests. The clinic screens for HIV and hepatitis C. If people test positive, the clinic connects them to the correct services “We fax the prescription for them and it’s waiting at the pharmacy when they get there,” says Ferris.
Generally, the follow-ups are by phone, a practice which has been more successful than in person follow-ups.
“Many people do very well on these medications. We’re having success with people,” she says.
In addition to the opioid agonist therapy, people succeed if they have family support, good relationships, a skilled job and safe housing — housing where their roommate isn’t using and they aren’t being threatened, says the doctor. “It’s really hard to get clean if you don’t have those basic supports in place, those very basic needs.”
Although the overdose deaths in tents on the Pandora strip are visible, the people who die there are not the typical user, says Ferris.
A recent B.C. Coroners Service report shows 58 per cent of overdose deaths on 91原创 Island happened in private homes. Twenty-three percent were in shelters or single-room occupancy and 16 per cent were outside in tents or cars. The average death is an employed man, aged 24 to 49.
People can be in treatment while still living at home and going to the rapid access addiction clinic for suboxone or methadone, says Ferris.
“Treatment is more than a place. If you have a safe place to live and you come to the clinic, you are out of withdrawal in a days or a week and you can maintain your employment.”
Suboxone works for some people, but it doesn’t work for those who are doing huge amounts of fentanyl. And some people don’t want to remove their ability to get high, she notes.
“We really try to dig into the mental health side as well. If somebody has trauma or anxiety or depression. We make sure they get treatment for that. We do have Island Health supportive counselling which is free.”
After patients have stabilized, they can be seen by one of 100 addiction doctors on 91原创 Island who can prescribe the opioid agonist drugs.
Ferris believes the solution to the toxic illicit drug supply is to end prohibition.
“You don’t need a doctor’s prescription to go buy a bottle of wine. Why should anyone need a prescription for their recreational substances? Why should a couple who want to do a little ecstasy on the weekend risk dying from fentanyl-contaminated stuff they bought on the street?” she asks.
Society is going in the wrong direction by only expanding prescribed safe supply, says Ferris.
“Look at what other countries are doing. Six European countries have legal heroin programs. They don’t have fentanyl. They don’t have an overdose crisis and you don’t get more people starting to use drugs.”
The Rapid Access Addiction Clinic can be reached at 250-519-3776.
• For information on mental health and substance use services, call CARES at 250-519-3485.
