Vancouver Coastal Health has developed a first-of-its-kind guideline for the treatment of opioid addiction. The guidelines are aimed at improving physicians’ knowledge of the various treatments available for opioid addiction.
Opioid addiction is a medical condition characterized by the compulsive use of opioids such as morphine, heroin, codeine, oxycodone, and fentanyl. According to Dr. Evan Wood, medical director of community addiction services at VCH, opioid use disorder is one of the most challenging forms of addiction facing the health care system in British Columbia.
There’s a strong need for evidence-based guidelines to educate physicians and other health professionals about the full range of treatment options for individuals with opioid addiction.
As Dr. Wood explains, “In recent years, science has enabled us to expand the options beyond just methadone to look at safer and more effective ways of treating the diversity of types of opioid addiction. So although methadone is a highly effective approach, not all patients need it and there are some challenges involved,” he says. “Essentially, what we’re encouraging physicians to do is generally start with the least toxic, most effective approach first, and proceed from there when necessary.”
The guideline, developed by VCH, Providence Health Care and representatives from the Ministry of Health, supports a diverse array of possible treatments, recognizing that different approaches are necessary for different patients and circumstances. These include using buprenorphine/naloxone (also known as Suboxone) as a preferred first-line treatment, since buprenorphine is six times safer than methadone in terms of overdose risk and has a safer side effect profile. The guideline also recognizes that most individuals will benefit from the ability to move between treatments, and highlights the role of support recovery programs.