On the record with Dr. Seonaid Nolan

published on July 15, 2016 by Rumana D'Souza in The Vancouver Courier

Q&A with Dr. Seonaid Nolan, physician lead for addiction medicine at St. Paul’s

Since 2007, Canadian health care providers, addiction experts and social workers have been calling on regulatory bodies to lift barriers that limit access to Suboxone, a substitute opioid used to counter opioid addiction.

Suboxone, a combination of two medications – buprenorphine and naloxone, has been used to treat opioid dependence in countries such as France, U.S., U.K. and Australia for many years, even replacing methadone as the first-line medication for opioid replacement therapy.

On July 1, the BC College of Physicians and Surgeons lifted a restriction, which will allow all doctors to prescribe Suboxone, making the drug more accessible to addicts.

Dr. Seonaid Nolan is the physician lead for addiction medicine at St. Paul’s Hospital and a research scientist at the BC Centre for Excellence in HIV/AIDS. Nolan was one of 73 physicians who submitted a report to the college recommending strategies to address BC’s opioid abuse crisis.

The Courier spoke with Nolan about the new regulation and why the college’s decision is a significant step forward in the treatment of opioid dependence in the province.

Why is this new shift in Suboxone treatment in BC so significant?

Before July 1, doctors who wanted to prescribe Suboxone for the treatment of opioid use disorder had to have a methadone licence. The new change allows doctors to prescribe Suboxone free of that licence. We know that Suboxone is a very effective medication for the treatment of underlying opioid addiction, so the new regulation put forward by the BC College of Physicians and Surgeons really improves access to this safe and effective medication.

Why has it taken so long to lift this outdated restriction on Suboxone?

It’s been a historical regulation by the college to link the prescribing of all opioid agonist treatments. The recommendation on the product monograph for Suboxone doesn’t necessitate the physician’s need to have a methadone licence to prescribe it. So it’s just been a historical practice pattern that we’re now re-evaluating in an attempt to improve access to this life-saving drug.