Aug. 9, 2019
Dear Editor,
I commend the Vernon Morning Star for its recent series on the overdose crisis. These stories help humanize the opioid overdose emergency and demonstrate that the path to recovery can take multiple roads.
The work outlined is an important step in decreasing stigma that underlies this epidemic. As an addictions medicine specialist, I often meet individuals who have been reluctant to seek help because they are worried about the stigma surrounding drug use. Some use drugs in high risk situations, such as alone at home, because they feel ashamed. This places them at increased risk of death if they overdose, as they are unlikely to be found and resuscitated in a timely way.
I do wish to clarify several important points.
In the article ‘Services and shortcomings’ (July 30) Houghton speaks about the need for more rapid access to withdrawal management (detox) and inpatient treatment beds. While these services are an important part of the continuum of care, for opioid use disorder specifically they are not a mainstay. According to provincial and national guidelines, withdrawal management is not recommended as a standalone intervention for opioid use disorder. If individuals attend withdrawal management without medication for long-term management of their opioid addiction, relapse rates are over 95 per cent. Furthermore, while attending a detox centre individuals lose their tolerance to opioids quickly, placing them at increased risk of overdose and death. Research around inpatient treatment for individuals with opioid addiction has shown similar outcomes; more than 90 per cent of individuals will relapse if not started on medications, and their risk of death doubles.
READ MORE: Part One: The opioid crisis and the B.C. Interior
READ MORE: B.C.’s opioid crisis leads to first stall in Canadian life expectancy in 40 years: study
Medication treatment is known as opioid agonist therapy (OAT) and helps manage cravings for illicit opioids, alleviate withdrawal, and protect against overdose death. The two primary medications are Suboxone and methadone. Far from being “one of the most highly debated treatment offered by Interior Health” as stated in the Aug. 3 article, OAT is the first-line recommended treatment for opioid addiction, with many years of evidence.
Houghton’s comment ‘your brain thinks you’re high [while on methadone]’ is inaccurate. With appropriate dosage, methadone does not produce euphoria or a ‘high’, but allows people to go through their day without using or craving illicit opioids, so they can focus on other aspects of their life that are important for their recovery.
To learn more visit the overdose emergency page at interiorhealth.ca.
Dr. Leslie Lappalainen, Regional Addiction Medicine Lead
Mental Health & Substance Use, Interior Health