Federal government green lights expansion of opioid treatment

A year after British Columbia declared a public health emergency in the wake of a seemingly unending overdose crisis, the federal government is finally responding to urgent calls across the country. This afternoon, it proposed a regulatory amendment that would significantly expand access to heroin-assisted treatment.

The process, if implemented, would allow for the importation and use of substances otherwise unauthorized for sale in Canada: this would include diacetylmorphine—more commonly referred to as heroin. Upon notification by one or more provincial or territorial public health officials, the federal Minister of Health would be able to remove barriers to importation for select substances.

We are very encouraged by these proposed changes.

"This proposal would simply allow for the importation of a drug included on the “List of Drugs for an Urgent Public Health Need” (the List) to address an urgent public health need, such as the treatment of opioid use disorder."

As people who live in Canada continue to die in devastating numbers from fentanyl-related overdoses, there has long been clear and pressing rationale to expand access to cleaner, safer substances through prescription programs.

Research trials carried out both locally (at Vancouver’s Crosstown Clinic) and internationally (in Switzerland, Germany, the Netherlands, Spain, and Denmark) have studied heroin-assisted treatment and proven the significant health and safety benefits for people with long-term addictions.

Vancouver’s studies demonstrated substantial health improvements for participants as well as remarkably high retention rates in the program. Participants’ involvement in illegal activities were cut by nearly half. Rates of illegal heroin use dropped dramatically, as did the amount of money spent on illicit drugs. 

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Despite the overwhelming success of such programs, access to this life-saving treatment has been overly restricted. Doctors have been forced to apply for the drug through the “Special Access Program”—a costly and burdensome process that must be carried out every three months on a patient-by-patient basis.

"Confidence that the drug meets a similar standard of safety, efficacy and quality to that of a Canadian authorized drug would be provided by the fact that these drugs have, in being authorized for sale in either the United States, the European Union, or Switzerland, undergone a thorough examination by trusted regulatory partners."

These barriers cost lives. Already this year, BC has lost a record 347 people to fatal overdoses. This puts the province on the trajectory to lose over 1,300 people by 2018. It is not acceptable to expect communities to continue to shoulder the burden of saving lives through supervised injection services. Nor it is reasonable to assume that the crisis will improve without more aggressive government measures to treat addiction as a public health issue.

For the full content of the federal government’s proposal, go to: http://www.gazette.gc.ca/rp-pr/p1/2017/2017-04-22/html/reg3-eng.php