Tuesday, February 09, 2021

ALBERTA UCP PLANS TO KILL SAFE INJECTION SITES
'A matter of life and death': U of C study details benefits of threatened opioid treatment program

An opioid dependency program facing looming closure by the UCP government has not only helped patients curb their mental health struggles and reliance on illicit drugs, but is the reason why many feel they are even still alive.  
© Provided by Calgary Herald 
The Sheldon M. Chumir Health Centre in Calgary houses one of two injectable opioid agonist treatment pilot projects in Alberta.

That’s according to a new University of Calgary study led by Jennifer Jackson, a registered nurse and assistant professor in the Faculty of Nursing.

Injectable opioid agonist treatment (iOAT) clinics in Calgary and Edmonton provide a form of treatment for people with an opioid addiction, for whom oral treatments such as methadone or suboxone have been unsuccessful. The service has been described as “the last chance for recovery” for patients.

Alberta’s iOAT pilot began under the former NDP government in 2018. But those clinics could close next month, pending the outcome of an ongoing legal challenge , after Premier Jason Kenney’s government indicated last year it would not renew a grant dedicated to the service past March 2021.

Jackson’s research, which was published Monday, concluded that the lives of patients “had drastically improved through the iOAT program.”

“Several participants shared that they were fearful they would be dead if the program were to cease operating,” she wrote.

The study included qualitative interviews with 23 iOAT patients in 2019, all of whom had chronic opioid use disorder. Thirteen participants accessing iOAT services were referred through supervised consumption services.

Patients described their lives having been “transformed” for the better by enrolling in iOAT. They cited a decreased reliance on street drugs, a decline in withdrawal symptoms and an improvement in their mental health, with fewer anxieties stemming from previous drug-related behaviours.

Many patients said they experienced life-threatening overdoses prior to participating in iOAT, but none reported any overdoses after enrolling in the program. Some said the program helped them step away from a previous lifestyle that involved crimes like theft and selling drugs.

Participants reported they were better able to care for themselves, rebuild relationships and find financial stability and secure housing after enrolling in iOAT.

“The only fear is I’m scared what’s gonna happen if the program ever stops,” one said. “What would I do? Like, that’s a scary thought.”

Jackson said the primary benefit of the program for many patients, according to their interviews, is the relationships they have built with clinic staff.

One participant said iOAT granted them “a place where I can come where I feel safe… where people don’t look at me like a junkie, like an addict.”

“They look at me like a person,” they said. “They talk to me like a person.”

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Jackson said she was surprised “by how significant the benefits were,” noting the program “is on par with the gold standard in other places.” Other studies of similar programs in the Netherlands and B.C. showed that when services were taken away, between 13 and 20 per cent of patients died.

“I’m confident that if this was a service that provided support for people with cancer or people with diabetes, we would see one in every town in Alberta,” Jackson said.

“Patients are aware that if this program is closed, people will die from it. I hate to say so with such certainty because it’s a really awful reality. It’s not hyperbole to say that this is a matter of life and death.”

Elaine Hyshka, an assistant professor at the University of Alberta’s School of Public Health, said closing iOAT clinics would remove “a fundamental component of the continuum of care for opioid addiction in Alberta.”

“There has been research done on what happens when people are cut off from medications and from medical care that they’re provided. It’s not good,” said Hyshka, who was not involved in the study.

“We know it’s very likely that many people return to street drug use and so they will relapse and no longer be in recovery. The drug supply is so toxic in Alberta and across Canada right now that there is a real chance that patients will die as a result of the decision.”
© Provided by Calgary Herald 
Edmonton lawyer Avnish Nanda says if the program closes, 
the potential for fatalities is “staggering”.

Last September, 11 chronic opioid use disorder patients issued a legal challenge against the provincial government’s decision to halt iOAT services, alleging it violates their constitutional rights. The government has said it intended to transition clients to “other appropriate treatment options.”

The office of Jason Luan, associate minister of mental health and addictions, declined to comment.

A court will hear arguments Wednesday for an injunction, which would prevent all iOAT patients from being denied the treatment until the lawsuit reaches a conclusion, even if the matter is still before the courts beyond March.

Edmonton lawyer Avnish Nanda, who represents the patients, said the potential for fatalities associated with the looming program closure is “staggering.”

“If that were any other treatment regime or medical program, I think that would alarm a lot of folks,” he said.

Nanda said Jackson’s research is “consistent with what everyone has said about this program and its effectiveness.”

“The science is clear that if this program is cut, we should anticipate between 13 to 20 per cent of these iOAT patients, these Albertans, are going to die within a year because of their condition, because they are unable to access this treatment.”

Jackson said she sent the findings of her research to Luan, along with the premier and Health Minister Tyler Shandro. She hasn’t received a response.

“I hope that they have the courage to keep what we have because it’s already working,” Jackson said.

“We’re not asking for anything new. We’re asking that what we have, we keep. That’s the quickest possible policy win.”

— With files from Alanna Smith

shudes@postmedia.com

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