The provincial and federal governments have announced $4 million in new funding for addiction treatment in the province, an initiative Premier Dennis King attributes to the Graphic’s investigation into mental health and addiction, Through the Cracks.
“It’s everything we hoped for,” says Dr David Stewart, a Charlottetown doctor who has worked for 28 years in addiction treatment. Dr Stewart called for universal opioid replacement therapy.
He says the announcement is a huge step forward by making medication accessible to all.
With this funding, starting June 1, Methadone, Suboxone, Probuphine, Sublocade to treat addiction to opioid addiction as well as Acamprosate and Naltrexone to treat alcohol addiction will be available to Islanders with prescriptions at no cost.
“The Eastern Graphic’s series Through the Cracks unveiled a simple solution to assist these Islanders who are on the path to recovery from substance abuse and after meeting with Dr David Stewart, it became obvious we needed to fully fund opioid replacement therapy drugs for all Islanders who are prescribed these treatments,” Premier Dennis King said.
A call for physician incentive
While just over $4 million is budgeted for the next four years, the real investment will depend on buy in to treatment, according to the Department of Health and Wellness. Opioid replacement therapy uptake might be hindered moving forward. The downtown Charlottetown methadone clinic reached max capacity, serving 800 patients in January and has since turned away at least 15 Islanders.
The volume of patients seeking treatment at the central location has increased steadily since it opened in 2014 when wait lists were reaching more than 300 people. Health PEI has not yet reported a wait list for the provincial program which serves between 300 and 400 patients and is accessed in Mount Herbert, east of Stratford. Dr Stewart maintains there are Islanders that would partake in treatment if it was more easily accessible at the private clinic downtown.
“The big issue underlying this is a lack of interest or perhaps put another way, a lack of incentivization for physicians to get involved in addictions treatment,” he said. He calls on government and Health PEI to offer financial incentive for doctors to serve Islanders in need of this life changing treatment.
Believed to be leading the country
“What’s exciting is funding medication for alcohol treatment,” Dr Stewart added. “We’re certainly ahead of the curve now.”
The change in policy will make accessing treatment far easier and put PEI among the leaders in the country for access.
In addition to cost-free treatment, prescription restrictions related to the drugs will be removed allowing smoother accessibility. A clause restricting prescriptions of Acamprosate for a maximum treatment period of 12 months will be removed from the provincial formulary.
To continue therapy using Naltrexone after three months information on the outcome of therapy as well as the patient’s compliance with treatment programs were previously required.
As of June 1, doctors will be able to prescribe at their independent clinical discretion.
Funding will be sourced through the four-year $35 million federal-provincial initiative Improving Affordable Access to Prescriptions Drugs, which was announced in August of 2021.
Investment in treating addiction could mitigate associated costs.
Addiction to opioids cost $29.31 million and addiction to alcohol cost $94.34 million on PEI in 2017, according to the latest assessment by the Canadian Centre on Substance Use and Addiction in partnership with University of Victoria.
Overall substance-related costs on PEI totalled $248 million according to the analysis. This is the highest amount per capita of all Canadian provinces.
Costs calculated in the analysis included lost productivity from potential years of life lost as well as long-term and short-term disability costs, health care costs such as emergency services, hospitalizations and surgeries.
Criminal justice costs such as policing, legal proceedings and incarcerations as well as other costs such as fire damage or workers compensation expenses directly related to substance use by category are also factored in.
Costs related to the effects on children with parents who suffer from substance use disorders like child protective services or care for related negative health outcomes (mental and physical) were not included.
Tessa Roger is an outreach worker for PEERS Alliance. She works with people with substance use disorders daily.
Ms Roger applauds the province and the federal government’s move to reduce barriers to treatment but encourages the province to push beyond abstinence focused efforts.
“It’s a common thing for all of these buzzwords to come up, like harm reduction or low barrier,” says Ms Roger. She calls on the government to continue forward matching this talk with action.
A clear step forward toward harm-reduction model of care on PEI would be for the province to develop a safer supply program, she says.
Safer supply refers to providing prescribed medications as a safer alternative to the toxic, illegal drugs to people at high risk of overdose. This program can help prevent overdoses and deaths, HIV, HEP C and other infections and connect people who use drugs to other health and social services.
Safer supply programs could be run through various outlets: supportive housing, community pharmacies, community health centres or supervised consumption sites. There are safer supply options in most provinces and territories but not PEI.
Another step could be a safer consumption site, otherwise known as an overdose prevention site. This has been on the province’s radar since at least 2018 when discussions started with local stakeholders. It has been repetitively touted by Dr Heather Morrison and her Chief Public Health Office as a service that would benefit Islanders.
“There is no evidence showing safer consumption services negatively impact public safety,” read a statement from the CPHO to The Graphic.
“The sites have been shown to improve public order by moving high-risk substance use from public spaces to safer private spaces, and by reducing the number of discarded sharps in public spaces.”
With research complete, the CPHO is looking to launch a safer consumption site pilot project as soon as possible, but is facing obstacles: finding an appropriate location and a willing and able non-government operator.
Rachel Collier, Local Journalism Initiative Reporter, The Eastern Graphic