Canada: Pandemic restrictions reshape opioid treatment as doctors sound alarm

By Carrie Tait, Marcus Gee & Andrea Woo for The Globe and Mail

Physicians across the country are relaxing their prescribing practices around medical treatment for opioid addictions in a bid to bolster physical distancing by cutting down on urinary drug screens and increasing the amount of methadone they give patients to take at home without supervision.

Health care professionals specializing in drug addictions were already struggling to cope with an epidemic of overdoses that has claimed thousands of lives across Canada before the worldwide pandemic. Now, the novel coronavirus is upending years of medical tradition and adding another layer of risk.

Doctors, nurses and harm-reduction experts are concerned their clients will catch the virus and succumb to it, given the often shaky health of those who use drugs. Access to supervised consumption sites for illicit substances and detox centres is also contracting, putting people who use street drugs at greater risk of overdosing.

Health Canada last month relaxed prescribing rules for some controlled drugs, making it easier for doctors and pharmacists to give people access to opioids. The changes mean some patients in opioid agonist therapy (OAT) programs will not have to make as many trips to pharmacies and clinics. It also means some OAT patients will have more access to larger quantities of medicine like methadone that can be fatal if not taken properly.

Patients in OAT programs take controlled doses of drugs such as methadone and buprenorphine-naloxone, which is known as suboxone, to manage opioid-withdrawal symptoms and create stability in their lives. Patients, particularly those on methadone, often have to take their doses under supervision at pharmacies or clinics. Stable patients are, over time, permitted to take home a limited number of doses, known as carries, but even the most trusted generally return to the clinic or pharmacy once a week for a supervised dose.