Saturday May 14, 2016
Breaking the Opioid Cycle
Canada follows US lead and moves to amend regulations
Staff/Voice file photo
A prostitute hangs out in downtown Chilliwack last month.
ealth Canada announced Friday that the department will propose a regulatory amendment to allow access to diacetylmorphine under Health Canada's Special Access Programme ("SAP").
A significant body of scientific evidence supports the medical use of diacetylmorphine, also known as pharmaceutical-grade heroin, for the treatment of chronic relapsing opioid dependence. Diacetylmorphine is permitted in a number of other jurisdictions, such as Germany, the Netherlands, Denmark, and Switzerland, to support a small percentage of patients who have not responded to other treatment options, such as methadone and buprenorphine.
"The SAP considers requests for emergency access to drugs for patients with serious or life-threatening conditions when conventional treatments have failed, are unsuitable, or are unavailable. Each request made under the SAP is thoroughly reviewed by clinical experts at Health Canada before being granted. Health Canada recognizes the importance of providing physicians with the ability to make evidence-based treatment proposals in these exceptional cases."
"The proposed regulatory change would move diacetylmorphine to the Narcotics Control Regulations, allowing applications to be considered under the SAP when a doctor considers it medically necessary. Under the proposal, other drugs listed in Part J of the Food and Drugs Regulations would remain available for research purposes. However, they would continue to be unavailable for access under the SAP, consistent with the amendments introduced in 2013, as they currently have no recognized medical use."
Health Canada stated that while some people would have access to the drugs, people outside of the program would still have to abide by the law.
"While the proposed amendment would enable the careful consideration by the SAP of applications for diacetylmorphine in exceptional cases, all the other stringent controls in the Narcotics Control Regulations will continue to apply."
Health Canada has published the details of this proposal in a Notice to Interested Parties in Canada Gazette Part 1, and stakeholders and members of the public are invited to provide feedback during the 30-day comment period.
The problem with most rehab is that 95% relapse after treatment. It's such a big issue, that last year, the US government gave notice to rehabilitation agencies across the country that if they only offered abstinence-based treatment options, then they wouldn't get any federal funding.
This has caused many who are in the business of treating people with addictions to rethink their programs and strategies.
Also on Friday, the BC Coroner's office released the latest numbers regarding overdose deaths in the province, stating that there were 480 apparent illicit drug overdose deaths in 2015, a 31.1% increase in deaths from 2014 (366 deaths).
In 2015, the illicit drug overdose death rate increased to 10.2 deaths per 100,000 population. Similar rates were previously seen in 1998 (10.0 deaths) and 1993 (9.9 deaths).
There were 76 deaths in January 2016; the largest number of deaths in a single month for the examined period (January 1, 2007 to April 30, 2016). The high number of deaths continued from February to April, 2016. In 2012, fentanyl was detected in 5% of the overdose deaths in BC. The percentage has steadily increased. Last year, fentanyl was detected in 32% of overdose deaths.
"The BC Coroners Service has posted the most recent statistics on illicit drug overdose deaths in British Columbia to its website.
The total number of illicit drug overdose deaths in B.C. to April 30, 2016, is 256. This represents an increase of 88.2% from the 136 deaths that occurred in the same period last year," said a release on Friday.
"Fentanyl was detected in 49% of the illicit drug-related deaths that occurred in the first three months of the year. This compares to 32% detected in these deaths for all of 2015. Fentanyl is most often detected in combination with other illicit substances."
"Those using illicit drugs are urged to exercise extreme caution, given the significant numbers of deaths involving fentanyl and the lethality of this drug. Chief coroner Lisa Lapointe stresses the critical importance of illicit drug users having medical assistance or a support person nearby in the event of overdose."
“Naloxone is now widely available in the province, including in some pharmacies without a prescription, and can be administered by anyone trained to use it,” Lapointe said. “This administration is often extremely successful in preventing what would otherwise be a tragic opiate drug overdose death.”
The report covers the first four months of 2016 (Jan. 1 - April 30) and can be found in its entirety here.
BC Overdose Deaths 2007-16
Chilliwack Overdose Deaths 2007-16
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