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Province approves guidelines for injectable drug addictions treatment

Guidelines created by the British Columbia Centre on Substance Use sets out the use of injectable prescription heroin and other drugs to treat addiction.

Mental Health and Addictions Minister Judy Darcy.

Jennifer Gauthier/Metro File / Vancouver Freelance

Mental Health and Addictions Minister Judy Darcy.

Doctors could soon have new options to treat people with severe opioid addictions in British Columbia.

The province has approved new guidelines Wednesday setting out how injectable prescription drugs – like heroin and hydromorphone – can be used by physicians to treat people with addiction.

Judy Darcy, Minister of Mental Health and Addictions, said British Columbia is the first jurisdiction in North America to develop such guidelines.

In the midst of the province’s overdose crisis, it’s a necessary step, she said.

“We need to provide every possible option to save peoples’ lives,” said Darcy. “Four people a day are dying. It remains the worst public health emergency we’ve had in decades. The evidence shows that these drugs can make a difference. They’re prescription drugs and they will save lives.”

Health authorities have been ordered, “to come back to us as quickly as they possibly can with a plan for implementing” the guidelines, Darcy said.

While current substitution therapies used to treat opioid addiction, like methadone, have proven to be effective, they don’t work for everyone, according to BC Centre on Substance Use clinical researcher Dr. Seonaid Nolan.

Injectables like hydromorphone are a more “high intensity” option for people with severe addictions, she said.

“Suboxone and methadone are supported by a large body of evidence … but there are some limitations to their use. Some people develop intolerance to the medications, side effects, or they can have difficulty starting the medication,” said Nolan, who helped develop the guidelines. “We know for a certain population of individuals, mostly those who have severe opioid use disorder who have failed either methadone or suboxone, that access to injectable opioid agonist treatment can be very effective.”

Nolan said the treatment has been shown to reduce people’s use of illicit drugs, keep people in treatment longer, lower the transmission of infectious disease and reduce patients’ interactions with health care services and the criminal justice system.

Darcy said the stigma around prescription heroin “runs very deep in our society” but defended the treatment.

“We need to start treating addictions and mental illness the same way we do any other physical illness, with the same dignity and respect and quality of care,” she said. “British Columbia is known as a leader in the field, in North America. We need to make sure we’re doing it right so these guidelines were worked on by all the people who needed to be in the room and reviewed by international experts. And the results will also be evaluated every step of the way. This is all evidence-based. This is about saving lives.”

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