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Canada’s Opioid Epidemic

Canadians currently have one of the highest per capita rates of opioid use, second only to Americans. Canadians currently have one of the highest per capita rates of opioid use, second only to Americans. And although we are in second place, opioid use in Canada is rapidly increasing. An abundance of opioid prescriptions, as well as easy access to illicit opioids is a cause for concern during an evolving ‘opioid epidemic’. Opioid death rates are climbing due to the introduction of illicitly-manufactured fentanyl—an extremely potent opioid. According to the CDC, deaths due to synthetic opioids increased 72.2% between 2014 and 2015. This staggering statistic indicates the need for effective addiction treatment, allowing for a reduction in opioid-related deaths.

Common treatments for opioid addiction include methadone maintenance treatment and buprenorphine. According to the World Health Organization, these are essential in the treatment of opioid addictions. Medical treatment is helpful for opioid addiction in several ways. First, it is a ‘harm reduction’ approach. Although a patient is still using an opioid, these are pure opioids of a measured dose. This eliminates the risks associated with taking an illicit opioid which may be cut with other damaging substances, and the risk of overdosing, due to taking a larger dose than expected. Secondly, these opioids do not produce the same euphoric effects of abused opioids, while still reducing the craving and withdrawal symptoms which often make combating an opioid addiction extremely difficult.

Methadone maintenance treatment has been used for opioid addiction treatment since the 1960s. Although it can be very helpful in treating an opioid addiction, there are some downsides to the use of methadone. For example, the tapering period, in which a patient decreases the dose of methadone to an eventual cessation of methadone use can be extremely long. This tapering period is much shorter and more manageable with the use of buprenorphine, allowing for a more successful and timely recovery. Furthermore, buprenorphine is marketed as Suboxone, which has naloxone, an opioid antagonist added to it. Naloxone prevents the effects of opioids. Therefore, when Suboxone is used as directed the buprenorphine prevents withdrawal symptoms and craving. However, Suboxone cannot be abused in the same way that methadone can, in an attempt to get high, because when taken in an unintended way the naloxone will inhibit the effects of the opioid. Therefore, Suboxone is safeguarded against abuse, while methadone is relatively easy to abuse. So easy that it is almost an invitation to abuse.

Opiate withdrawal can be a frightening concept for many individuals. It need not be so. There is no need for detox to be a debilitating experience. The physicians at Searidge Foundation have specialized training and extensive successful experience with opioid withdrawal and detox, and can make it a safe and comfortable process. When under our medical supervision, a patient will feel mentally and physically well, and can fully participate with counselling treatment and recreational activities while the detox proceeds. Painful opiate detox only occurs if a cold-turkey un-medicated withdrawal is attempted. That would be like having your teeth drilled without anaesthetic, and who would want that.

Our usual first choice when treating an opioid addiction is complete opioid detox. In some cases however, a complete withdrawal is not a reasonable near term expectation, and individuals need to be stabilized on Suboxone for a period of time before total withdrawal can be considered. In those instances, psychotherapy and counselling is tailored to support a sustained and lasting recovery with the ongoing support of Suboxone. Patients in those circumstances continue to get medical care from our doctors, and also receive more intensive Aftercare support, specifically tailored to enhance opiate replacement therapy and make sure they get the maximum benefit from their medication.

Indeed, medication is a useful tool in the treatment of opioid addiction, but it is not the only part of a full recovery. To address the underlying causes and treat the patient’s health, psychotherapy should also be used in addiction treatment. Combining both medications and therapy allows for the patient’s health to be addressed in a holistic manner, not only allowing for the individual to discontinue their drug use in a timely manner, but also preventing future relapses.

At Searidge Foundation psychotherapies such as Cognitive Behavioural Therapy (CBT), Rational Emotive Behaviour Therapy (REBT), Psychodynamic Therapy and Cognitive Bias Modification (CBM), are used in conjunction with medicated opioid withdrawal, allowing for patients to successfully recover and decrease their risk of future relapses. Patients are given the opportunity to take part in both group and individual therapy sessions, facilitating a holistic recovery and treatment of the underlying causes of their addiction. Searidge Foundation continues to partner with leading-edge researchers to find and develop effective treatments for individuals suffering from opioid addictions, assuming an active role in combating the opioid epidemic which is sweeping our nation.

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National Association of Addiction Treatment Providers International Security for Traumatic Stress Studies The Canadian Positive Psychology Association The Association for Addiction Professionals