All Canadian communities are affected by the opioid crisis. Every meeting I hold leads to a flash mob. My staff put up pictures of patients and their loved ones affected. One time a photo of a man from Moncton was pulled out of the stack of images. He was a man who fell right into this category. Another patient whose photos I always note is from Lethbridge, Alta. Tragically he was 19 when he overdosed.
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These young people are far from the people police first saw playing Russian roulette with hidden drug-filled syringes in their backpacks. These poor souls did not have access to fentanyl, heroin, OxyContin, or any pharmaceutical drug in their complex daily lives. They wanted to experience the high of a pharmaceutical drug. The addictions started through their use of prescription drugs. Then as the prescribed drugs were discontinued their grief, addiction and withdrawal took root in the hope for the high a pharmaceutical drug can deliver.
Fortunately, every year there are many Canadians turning to alternative medicines and holistic therapy. When clinical facilities and doctors balk at these people, thanks to the obvious opioids that are too high, they turn to other therapies. These new therapeutic practices, in turn, are offering safe options for people who can’t get the traditional prescriptions.
Canada has a full-time addiction medicine physician, a full-time clinic staff, and the integrated addiction services offices already established in every hospital across the country. Government funding is routinely aligned with payment models which reward a range of holistic health services. The sensible approach makes efficient use of medical and non-medical resources. In this area, Ottawa should set a new precedent.
Ottawa, like many cities in North America, can provide addiction management teams with the appropriate expert and support services to patients. At the same time, however, its regulatory framework is weak. In some instances, addiction treatment has been regulated by the Classification and Evaluation Department of Health. In other cases, it has been regulated by provincial, non-health regulators.
Until last year, dealing with addiction in Ontario left treatment providers largely on their own to bring in and manage more clinical staff in order to manage their patients effectively. We now have a regulatory framework set by the Ontario Ministry of Health to guide the process to incorporate additional clinical staff in our treatment and recovery programs.
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But since Ontario’s regulatory framework – one in which all health professionals make their own case on how appropriate they are to work with their patients’ conditions – has been in place, no change in the amount of on-site pharmaceuticals has occurred.
It is possible that in the next 2 to 5 years more medical resources will be required in most areas of Canada, where Canada will need to draw on the experience and expertise from other provinces. Government funded research is being studied in every province. Given Ottawa’s strong advocacy role in the overall planning of the comprehensive federal-provincial addiction strategy, they should take an active part in the implementation, particularly in providing funding for expanding our capacity.
The federal government has too often attempted to walk the line between reality and fiction on drug policy. They often play the role of the moral arbiter on a shared national space in which we as a nation, must feel increasingly under the pressure of the unprecedented number of young Canadians struggling with addiction. A powerful national voice for the right kind of regulation and funding, to bring us closer to our goal of putting addicted families first, would reflect a politically wise approach.
• Kevin MacDonald is chief executive of the Canadian Association of Addiction Professionals