Detox not the answer for opioid crisis, says chief medical officer

Removing stigma and opening clinics offering free suboxone is the answer, says Dr. Victoria Lee

Detox for opioid addicts doesn’t work and can, in fact, be deadly, says Dr. Victoria Lee, Fraser Health’s Chief Medical Health Officer.

Instead, Lee suggests the answer is to provide methadone and suboxone at drop-in clinics within the community.

“We often think of treatment beds when we think of how to treat drug addiction. But detox treatment can increase the chance of overdose deaths when treating opioid addiction,” she said.

“Substance abuse affects all aspects of a person’s life and how they function.

“They are engrossed in the chaos of getting the next fix. If we remove that craving, [by providing methadone or suboxone] they can gain order back into their work and home life,” said Lee.

It means that people can be functioning members of society, but may have to be on suboxone their whole lives.

The problem with detox for opioid addicts is that too many suffer relapse and when they do, they can more easily overdose and die, she said.

“Because they have weaned off opioids, they then go cold turkey at the treatment centre. They tend to relapse and when they do, the dose they take is much stronger in their system.”

Fraser Health is pushing for a community based treatment approach with clinics offering suboxone prescribed by doctors at that clinic.

Lee said they have a clinic site available in Langley and doctors waiting to staff the clinic. They just need support from the community and municipal council.

Lee said Fraser Health wants to open a community clinic in Langley right now, but isn’t finding community support for it at the moment. She said she has doctors willing and able to work at the clinic to work with people addicted to opioids.

“People are worried about the kinds of people who hang around these clinics. I can appreciate where the stigma comes from, but from a physician’s point of view, we want to treat the disease, just like we would treat diabetes.

“People with type 2 diabetes often get it because of lifestyle choices of being unhealthy, but we don’t judge them in the same way we judge substance abuse.”

The latest numbers from the B.C. Coroner’s office are staggering and indicative of a crisis that is only getting worse. More than 1,100 drug overdose deaths took place from January to September this year in the province. That is a 147 per cent increase over the same period last year.

But Lee wants to emphasize that the majority of overdoses are happening inside homes, not on the streets.

“People are dying because of the level of stigma attached to drug addiction. Seventy per cent of the overdose deaths were at home.

“People are dying rather than ask for help. If we remove that stigma and start looking at this as a medical condition, it would save lives,” said Lee.

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