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A call for more opioid dependence treatment

A new report from researcher Bohdan Nosyk calls for the expansion of heroin and opioid to stem the increase of overdose deaths.

“Prescription opioid abuse and overdose is on the rise throughout North America,” says the associate professor and lead author of the study that was published in Health Affairs. “ is now the second-leading cause of accidental death in the U.S., behind only motor-vehicle accidents.

“People from all walks of life, including youths, are accessing these drugs and the consequences are deadly.”

The report highlights increases in the prevalence and hazards related to the use of opioids, such as heroin, and prescription opioids like oxycodone, in Canada and the United States, and the gap in treatment availability in both countries.

Evidence shows that methadone and buprenorphine, two forms of opioid substitution therapy, are effective at retaining clients in treatment. Prolonged retention in treatment can lead to reductions in illicit drug use, overdoses, behaviours that increase the risk of contracting HIV, and criminal activity. As a result, treatment has been shown to be highly cost-effective.

The study makes several recommendations to expand access to evidence-based medical treatment, including:

  • Eliminating restrictions on methadone prescribing
  • Reducing financial barriers to treatment
  • Reducing reliance on opioid detoxification treatment
  • Integrating emerging treatments

There is serious concern for the consequences that may result if effective opioid continues to be limited, says Nosyk, who is also a health economist with the B.C. Centre for Excellence in HIV/AIDS.

“In the absence of readily-available treatment, some of the prescribed opioid users who are becoming dependent will switch from pills to injecting heroin in search of a more potent high,” he says.

“This would compound the challenges we have in the fight against HIV/AIDS and Hepatitis C at a time when new technology and treatment options for these conditions are turning the tide.”


ANALYSIS & COMMENTARY: A Call For Evidence-Based Medical Treatment Of Opioid Dependence In The United States And Canada

Bohdan Nosyk,M. Douglas Anglin,Suzanne Brissette,Thomas Kerr,David C. Marsh,Bruce R. Schackman,Evan Wood,and Julio S.G. Montaner; Health Aff August 2013 32:1462-1469; doi:10.1377/hlthaff.2012.0846

Simon Fraser University