While many factors are blamed as contributing factors in North America’s opioid crisis and overdose, Canadian hospitals and clinics are handing out naloxone kits as a stop-gap measure for at-risk opioid users. But it can be a tricky time at any point to deal with a loved one’s addiction, whether it be to Vicodin or heroin.
What does existing science say you can do to help someone you care about? For over three decades, Maia Szalavitz, author of “Unbroken Brain: A Revolutionary New Way of Understanding Addiction,” has presented the evidence that should play a vital role when weeding through conflicting advice in a field that she states is largely unregulated. Searching out care based on scientific fact as opposed to personal and clinical experience can improve recovery chances.
Her article “What Science Says To Do If Your Loved One Has An Opioid Addiction” is an excellent, evidence-based guide derived from the best research available on addictions, including systematic reviews and clinical medication trials. Szalavitz lays out how to accurately assess the problem, delves into the psychology of addictive behavior, and suggests how to intervene gently. Then, most importantly, she explains how to choose a treatment that is research-based.
Studies suggest that most people with addiction eventually recover, a far cry from the bleak picture portrayed in the media. Recovery from an opioid addiction can look different for different people, but no doubt is rooted in two key aspects: medical assessment and a long-term maintenance program. At least, so says the World Health Organization and the Institute of Medicine, for starters. Read on for more on the science to help you help your loved one on the road to recovery.
Dr. Arlene King of Fraser Health Authority and former chief medical officer of health of Ontario gave an update on the evolving overdose epidemic in Fraser Health region, which covers communities from White Rock to Hope, British Columbia. On September 21, the chief coroner of BC had announced 488 overdose deaths to date in BC, a 62% increase compared to the same time in 2015. According to Dr. King, who gave a plenary presentation on September 23 at the 2016 Pacific Psychopharmacology Conference in Vancouver, more than 60% of deaths in Fraser region were related to fentanyl, and if the current trend continues through 2016, 258 people will have died of overdose in the region. Although most people who die of overdose have a chronic substance-use disorder, young, naïve users are at high risk because of the presence of fentanyl in a wide variety of substances sold in the black market in BC. Fentanyl is a potent legal opioid, but the street form is mostly imported from clandestine markets in Asia. Fraser Health Authority is undertaking a variety of measures to prevent lethal drug overdoses; more information is available on Fraserhealth.ca .
On the previous day, Dr. Annabelle Mead, lead physician for Heartwood Centre for Women and an addiction medicine consultant for Vancouver Coastal Health, described the evidence for providing take-home naloxone kits and overdose education to prevent deaths. Naloxone kits are available in communities across BC, and specific outlets are posted on the Web site Toward the Heart which is maintained by the BC Centre for Disease Prevention. The site offers information about a variety of harm reduction approaches including a link to Insite, North America’s first legal safe-injection site in the Downtown Eastside of Vancouver. In other Canadian cities, efforts are underway to open safe-injection sites, which have strong evidence for preventing disease transmission and fatal overdoses, but no site has yet been announced in the Fraser region.
Drs. Ric Procyshyn, Christoph Correll, and Bill MacEwan visit the Downtown Eastside of Vancouver