Project that kept more addicted patients in treatment expands across B.C.

VANCOUVER — A pilot project in Vancouver is being expanded across British Columbia after more than double the number of drug-addicted people stayed in treatment to prevent them from fatally overdosing.

The initiative led by the BC Centre for Excellence in HIV/AIDS and Vancouver Coastal Health uses the same strategy that helped drive down the province’s HIV and AIDS rates and manage patients with other chronic conditions such as diabetes.

Dr. Rolando Barrios, the centre’s senior medical director, said a revamped system of care involves a team of doctors, nurses and social workers who take simple steps such as calling patients who don’t show up for appointments and work to address their other needs such as housing and employment.

The pilot at 17 clinics involved 1,100 patients and showed seven out of 10 of them stayed in treatment after three months, up from three out of 10. The program prescribes substitute opioids such as suboxone and methadone to curb illicit-drug cravings and ward off withdrawal symptoms.

Barrios said retaining people who are addicted to opioids like heroin and fentanyl in treatment is the biggest hurdle in the overdose crisis that has claimed 3,600 lives in B.C. alone since 2016.

The project includes practical help including reminding patients when their medication is about to expire and having pharmacies connect with health-care teams when people don’t pick up their medications.

“We’re hoping that adherence to treatment will improve their overall outcomes and eventually, which we cannot document right now, will decrease overdose and mortality,” he said Thursday.

Dr. Patricia Daly, chief medical health officer of public health for Vancouver Coastal, said lowering HIV rates involved setting targets to identify 90 per cent of patients in B.C. and keeping them on treatment.

“Most people who are dying are known to the health care system. They may even have started on treatment at some point in their lives but we’re doing a terrible job with retaining them on treatment, which probably needs to be, in some cases, lifelong or certainly for many years,” Daly said.

“We know that people with addiction relapse, that’s the norm, that it’s not necessarily a curable condition. They could be in long-term recovery but they need to stay on that treatment to prevent death.”

Guy Felicella battled a 20-year addiction to heroin and overdosed six times after fentanyl hit Vancouver’s Downtown Eastside. He finally sought opioid replacement treatment that had him taking suboxone for nine months, starting in 2013.

“What that provided was stability so I wasn’t hell bent on using fentanyl every day,” he said, adding he now works in the neighbourhood to help others in the same grip of addiction, alongside a nurse who once saved his life.

He is also providing his perspective to teams involved in the new initiative and said they are providing more than care as they allow people in the depths of despair to see they are valued enough to call, track down and keep alive.

“The biggest piece is human connection,” he said, adding outreach workers who tried to help him eventually had him change the path of life that now includes a wife and two children.

“I’m really, really happy they’re moving across B.C. now,” he said, adding the project has identified gaps in care that needed to be filled.

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