Vancouver Coastal Health sets new guidelines for treatment of opioid addiction

published on November 3, 2015 by Tiffany Crawford in The Vancouver Sun

Vancouver Coastal Health has established a first-of-its-kind guideline in the treatment of opioid addiction, including that doctors use a safer drug than methadone as a first line treatment.

The health authority says the nine recommendations in the guideline are aimed at improving physicians’ knowledge of treatment in light of ongoing challenges with methadone, and opioid overdoses linked to fentanyl and prescription drugs like oxycodone.

Dr. Evan Wood, the health authority’s medical director of community addiction services, says methadone, while a highly studied form of treatment, has many safety issues, including side effects, addiction, and fatal overdoses.

So the guideline directs doctors to use buprenorphine/naloxone (also known as Suboxone) as a preferred first line treatment. Although the drug has been available for decades, Wood said doctors in Canada have used it as a last resort, after methadone failed.

“In some ways, BC has had it backwards,” he said, of prescribing methadone before buprenorphine. “Essentially, what we’re encouraging physicians to do is generally start with the least toxic, most effective approach first, and proceed from there when necessary.”