To reduce drug overdose deaths, Vancouver Coastal Health authority plans to track patients to make sure they are taking their prescribed opioids.
I may seem odd that lives can be saved by making sure that patients take one opioid (Methadone) so that they don’t die from another (fentanyl). But that’s what statistics show. If patients stay on Methadone they’re more likely to be alive a year later.
It’s the first program of its kind in Canada and the latest effort to turn the tide on the opioid crisis that is projected to kill 1,500 British Columbians (Globe and Mail, Sept. 15, 2017). That’s up from 914 in 2016.
The problem is that patients have hectic lifestyles that make daily prescriptions difficult to take. As a result, only one-third are still on Methadone after a year. Laura Shaver, board member of the B.C. Association for People on Methadone, supports the plan:
“I would think it would be a great idea for many people that are, you know, a little bit unstable, for them to have a bit of a push behind them. With a bit of support, things could be a lot different.”
Rolando Barrios, assistant director at the Vancouver Coastal Health, sets his goal at 95 per cent Methadone compliance:
“We may not achieve that, but think about doubling the 30 per cent to 60 per cent . . . and the impact that would have.”
Tracking Methadone patients is labour intensive. The unregimented lifestyles of drug addicts make it difficult for them to make daily appointments. Starting this month, 20 teams, each comprising of three health professionals, will check on 3,000 patients to make sure they are taking their drugs.
Pharmacists will alert the teams if patients have not taken their daily dose. The team will then phone or visit the patient to check up. Participation in the program is voluntary: the teams are not policing patients.
The plan is modeled on the highly successful program to stop HIV/AIDS launched in 2010. It actively sought untreated HIV-positive people and followed up with an antiretroviral therapy. As a result, the transmission of AIDS was reduced by 96 per cent.
“With HIV,” says Dr. Barrios, “we used to wait until people had low immune systems before they started treatment . . . and then science came in and said we need to treat them earlier and faster. We learned that we needed to be aggressive.”
If the plan is so good for Vancouver, why isn’t it being applied throughout the province? Vancouver’s drug deaths may make news but the problem is worse in B.C.’s interior on a per capita basis.
Kamloops is bad -40 people died of drug overdoses in 2016- but Kelowna is worse. Kelowna led all Canada in per capita opioid poisoning hospitalizations. Vancouver was 16th. Kamloops didn’t make the top twenty but the program is needed here.
The Interior Health Authority needs to match the efforts of Vancouver Coastal Health. Users of prescription opioids need to be monitored. Only by reaching out will the death rate be brought down.