'It continues to destroy lives': B.C. doctors combating the opioid crisis desperate for more help
Published Tuesday, May 28, 2019 10:00PM EDT
In New Westminster, B.C., just steps away from the city’s main shopping district, there is a building that backs onto an alley. While it’s small and nondescript, it is also extremely busy.
The Lower Mainland Drug Freedom clinic isdedicated to treating opioid addiction. Dozens of people come here every day to get help from a specialized team of doctors.
More than 10,300 Canadians have died of opioid-related overdoses in less than three years. The Public Health Agency of Canada says the majority of those deaths are linked to fentanyl, an extremely powerful synthetic drug.
“When I hear the phrase ‘the opioid crisis’, I think about the patients I have seen. These are not just numbers, these are people with families that have been devastated and destroyed,” said Dr. Adam Chodkiewicz, one of the clinic’s physicians.
Chodkiewicz is a psychiatrist and addiction medicine specialist, with more than 20 years of experience.
“The patients I have are from all walks of life,” he said. “Some are professionals, some are Master’s students, some are trades people and some are patients that are more marginalized.”
Working alongside Chodkiewicz is Dr. Paul Sobey,who also specializes in substance abuse treatment.
“When I see an individual with opioid disorder, I ask myself, how to best engage that person in meaningful treatment that will result in them not experiencing further harms,” Sobey said.
The clinic provides access to methadone or suboxone –medications that work to prevent withdrawal and reduce cravings for opioids. The therapy, which is called Opioid Agonist Treatment, is meant to help reduce the harms related to a patient’s drug use.
Along with eight other doctors, Sobey and Chodkiewicz provide treatment to some 400 patients.
The workload is heavy and can lead to burnout. A recent Canadian study, by researchers at Western University found physicians are increasingly exhausted and overwhelmed by the epidemic.
Another difficulty in treating opioid addiction is that it can coincide with another disorder. Both doctors say many of their patients suffer from mental health issues.
“I would say that about 60 per cent of individuals I see at the clinic or in the hospital have a concurrent disorder, such clinical depression or post-traumatic stress,” Chodkiewicz said. “You can’t treat one without the other or you will always be playing catch-up.”
In addition to medication, the doctors help their patients access counselling and other support programs. If more intensive treatment is required, they assist people in finding residential rehabilitation programs. But getting the right treatment, at the right time, is not always easy.
“You can run into problems when trying to access treatment for these patients,” said Sobey. “This patient population can be complex and often require different forms of therapy.”
Some of the barriers can be limited space in addiction programs or a lack of beds in detox centres. Both the B.C. and federal government have pledged to increase access to treatment, but the doctors say they still struggle to get immediate help for patients.
“Sometimes you can get patients into treatment in a week, but sometimes you are waiting up to four weeks and often by then they have lost their motivation or started using again,” Chodkiewicz said.
Quick access to treatment was essential to Bobby Jeboult’s survival. The 28-year-old musician almost died after taking a couple pills laced with fentanyl. He’s been a patient at the clinic for four years and is now in recovery thanks to the help he received.
“I am lucky to be alive,” Jeboult said. “Once I recovered from the overdose, the doctors at the clinic helped me stabilize with medication and counselling.”
Sobey and Chodkiewicz say doctors need more resources to help people such as Jeboult. In addition to greater investments in treatment infrastructure, they would like a database built to better tracks patients moving towards recovery. Canada currently does not have a single national electronic health record system for patients.
“Information plays a big role and it would be good to have everyone treating a patient be able to access the same electronic record,” said Sobey. “So I can long on and see …my patient who went to residential treatment is in treatment, what notes there are and what another physician may be seeing.”
Adding to that, Chodkiewicz said: “to overcome what we are facing we have to eliminate the silo effect where everyone does theirthing separately.”