New efforts to expand treatment for opioid users in Victoria are putting addiction specialists in hospital emergency departments and supporting family doctors who provide opioid substitution therapy for patients.
The initiatives by Island Health and the Victoria Divisions of Family Practice are intended to dovetail with the work of the South Island Rapid Access Addiction Clinic that opened in the city early this year.
The clinic offers streamlined access to opioid replacement therapies including methadone and Suboxone. It saw 116 patients in its first five months of operation.
- Rapid access to opioid replacement therapy expands in Victoria
- People with addictions, advocates, combine to write opioid substitution therapy survival guide
- B.C. College of Physicians and Surgeons lifts 'outdated' restriction on Suboxone to help overdose crisis
Dr. Ramm Hering, Island Health's physician lead for the clinic, said initiating Suboxone treatment is "tricky", but it is easy for a family doctor to continue the treatment once a patient has been started on it.
"What the rapid access clinic is doing is connecting with family physicians, supporting them so that addiction can be treated, primarily by family physicians," Hering told On the Island's Khalil Ahktar.
"Because ultimately it is a chronic disease that is best treated by primary care physicians," Hering said.
Dr. Bill Bullock, a board member with the Victoria Division of Family Practice, said so far not a lot of family physicians in Victoria are taking on patients who need continuing Suboxone prescriptions.
While a number of doctors are interested in helping those patients, Bullock said, "These are skills that family physicians up to now, in general, have not had.
"There is in the maintenance phase, adjustment of doses, knowing when to go up, when to go down, when to taper people off," he said.
'Aren't used to doing this'
"There are other things such as the need to regularly monitor patients with urine and drug testing. Again, family physicians aren't used to doing this."
In response, the Victoria Divisions of Family Practice has taken a role in the education of the physicians and held events.
One session specifically educated physicians about using Suboxone — the commercial name for buprenorphine — in their practices.
Another Island Health initiative placed addictions medicine specialists in hospital emergency rooms to offer specialized care for patients with injuries or illness related to substance use.
Herring said the plan is to increase addiction care in hospitals and also connect patients to addiction care outside the hospital.
Bullock said it is a misconception that people with addictions don't want to quit using.
"I would say they're very willing," he said. "There are very few people who are caught up in a drug using lifestyle that are happy with their situation.
"People, after they've been using opiates for a certain length of time, the only reason they continue to use is they get sick if they don't use." he said.
Listen to the interview with Dr. Ramm Hering and Dr. Bill Bullock: "New measures boost addiction treatment access in Victoria"