By Canadian Press

Feds ease restrictions on prescription heroin to address opioid epidemic

Mar 26, 2018 | 7:45 AM

OTTAWA — Access to treatment for opioid addiction is about to get easier as the federal government promises changes to drug laws that would do away with some of the obstacles preventing doctors from offering prescription heroin and methadone.

Forthcoming legal changes will allow patients to access, when appropriate, prescribed heroin outside of a hospital setting, such as addiction clinics, making it easier for them to balance their treatment with daily responsibilities.

The government is also making methadone more accessible, allowing health-care practitioners to prescribe and administer it without needing to apply for an exemption from federal law.

Health Minister Ginette Petitpas Taylor said Monday that removing barriers to treatment is crucial to combat what her department describes as a national public health crisis that continues to devastate families and communities.

“We know way too many parents, sisters, brothers, daughters, sons or loved ones who have died because of opioids,” Petitpas Taylor said. “I believe we can turn the tide on this crisis. And we can do it together.”

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Health Canada estimates about 2,900 people died in 2016 as a result of the crisis; estimates slated to be released Tuesday suggest the epidemic claimed more than 4,000 lives last year.

The Controlled Drug and Substances Act currently requires that physicians apply for an exemption from federal law to be allowed to prescribe, administer, sell or provide methadone.

The government’s announced changes will mean doctors no longer require an exemption, something Petitpas Taylor called a barrier that discourages the treatment from being offered.

Nurse practitioners who work in one of the six provinces that already allows them to prescribe methadone will also no longer be required to apply for an exemption — those include Nova Scotia, New Brunswick, Newfoundland and Labrador, Manitoba, Alberta and British Columbia.

The new regulations are expected to come into effect in May and stem from a guideline released earlier this month by the Canadian Research Initiative in Substances Misuse.

The collection of best practices, put together by a network of 43 health-care practitioners, includes suggestions on how best to manage opioid-use disorder, including recommendations around what replacement medications should first be used to treat people addicted to powerful narcotics.

A network of doctors has developed a new Canadian guideline for managing opioid use disorder, including a recommendation that the opioid replacement Suboxone, a treatment considered to have safer side effects than methodone, should be the first medication used to treat those addicted to the powerful narcotics.

Last month’s federal budget earmarked $231 million to improve access to treatment, address stigma and gather data on the opioid crisis.

That includes $18.7 million over five years to tackle the stigma faced by people who use drugs, which includes a public education campaign aimed at changing stereotypes.

“Stigma is a huge barrier for people getting the treatment that they need. And it’s not acceptable,” Petitpas Taylor said.

She did not provide a date for when the education campaign would roll out, but emphasized it would happen as soon as possible.

Dr. Jeff Turnbull, director of Ottawa Inner City Health, which provides health care to the homeless community, said improving access to opioid-addiction treatment is welcome news, but much more remains to be done beyond stabilizing a medical condition.

“You have to find stable housing, you have to find support, you have to treat their underlying mental health problems and their addiction is all part of that,” Turnbull said. “The real work begins now.”

Deirdre Freiheit, head of the Ottawa-based harm-reduction organization Shepherds of Good Hope, applauded the announcement and stressed the importance of tackling stigma.

“Our clients have been vilified often by many rather than supported,” she said. “They’ve been judged for being in crisis rather than being supported. People have placed barriers in front of them — physical, emotional, systemic — rather than broken them down.”

Of the $231 million set aside in the federal budget for the opioid crisis, $150 million will go to provinces and territories to improve access to treatment, about $32 million will help border security intercept fentanyl and other illegal substances and nearly $18 million will improve research and access to public-health data and analysis.

— Follow @gwomand on Twitter

Geordon Omand, The Canadian Press