The center publishes updated national clinical guidelines for the treatment of opioid disorder

As more evidence emerges that opioid overdose deaths have increased dramatically since the advent of COVID-19, the Center for Addiction and Mental Health (CAMH), in collaboration with subject matter experts and medical regulators across Canada, has now published updated national clinical guidelines for the treatment of opioid use disorder. “Opioid Agonist Therapy: A Synthesis of Canadian Guidelines for the Treatment of Opioid Disorder” harmonizes existing provincial and national guidelines, evidence-based practices, and expert opinions in a paper on provide consistent, high-quality care to people with opioid use disorder.

The first-line treatment for those with opioid use disorder is opioid agonist therapy (OAT). This includes providing a medication that keeps the person away from abstinence, reduces their cravings, and prevents death from overdose in the event of a relapse. These drugs are the most effective treatment option for opioid use disorder and have been scientifically proven to save lives, even when people use fentanyl. When combined with counseling and addressing the social causes and consequences of addiction, the person can fully recover and relive their life. OAT is a long-term treatment and some people may take a few tries before it can fully improve.

“COVID has drastically changed the situation on the ground across Canada in terms of the opioid crisis and there needs to be living patterns that can be updated as circumstances change and new evidence evolves,” the doctor said. Peter Selby, science clinician, Addictions Division, and CAMH lead this initiative. “For example, we wanted to change some of the old rules that made it difficult to provide person-centered care and help people stay in treatment. This is key because the more people in treatment, the better they recover and the less chances are they will have to die from an opioid overdose. “

The new guidelines are updated with the most up-to-date information and clinically proven strategies to help patients overcome opioid addiction. These include up-to-date drug supply options, such as injectables, and expanding the list of medications for those who do not respond to traditional treatments. The guidelines also include fewer regulatory restrictions and new strategies to combat stigma to facilitate adherence to treatment.

“The OAT, like any other substance use treatment, must meet the individualized needs and goals of all patients,” added Dr. Narges Beyraghi, a psychiatrist at CAMH Addictions. “The recovery path is different for each individual and can be connected to different components of care during this process. This updated guideline has attempted to include gender, age, and others. mental health problems that could be a barrier to accessing equitable care or attention. “

A CAMH study published in April found that a large number of people who regularly used opioids when the pandemic began reported increased fears of dying from an overdose, largely due to disruptions in the supply of street drugs that made drugs more expensive, were more difficult to obtain and of unknown origin. or power. Blockade measures across the country also increased the risk of people using them alone without anyone helping them in the event of an overdose. This risk was exacerbated by reduced access to damage reduction services, such as safe injection centers. All these factors made experts afraid that the COVID pandemic would make the opioid crisis more deadly and new. numbers recently published by Ontario Public Heath confirmed these fears, with a 60% increase in opioid deaths.

Dr. Marina Reinecke, a medical consultant in the Manitoba College of Physicians and Surgeons Prescription Practice Program, said: “Opioid use disorder affects a large and diverse group of Canadians. In Manitoba, our patients live in urban, rural and remote locations and have diverse care needs. These needs often clash with unequal access to health care services. This aggravates the tragedy associated with this highly treatable disease. These guidelines provide evidence-based guidance and practical information for front-line physicians in all healthcare settings, allowing them to bring hope and health to Canadians where they live. ”

“However, the guidelines alone do not change the practice,” Dr. Beyraghi added. “What the practice of change means is a combination of policy changes to address stigma and structural and social education. We have several courses at CAMH that help providers acquire and improve their skills in dealing with people with opioids use disorder in a humane and respectful way. We also have excellent resources for people who use opioids and their loved ones to make an informed science-based decision about treatment. ”