By Fran Yanor / Legislative Reporter

An opioid agonist treatment clinic could serve the 3,225 people (2016 Census) living in the communities of Dome Creek, Urling, Crescent Spur, Goat River, McBride, Dunster, Tête Jaune Cache, and Valemount within the the 15,220 square km McBride/Valemount Community Health Service Area. Map courtesy Provincial Health Services Authority.

The Robson Valley has a community need for a dedicated opioid treatment clinic for people dealing with substance use addictions and mental health issues, say two Valemount physicians.

“We have been looking at trying to start up an opioid agonist therapy clinic,” said Dr. Ray Markham, chief of staff at the Valemount Health Centre. “I certainly don’t think a formal clinic is the panacea, but it may offer a couple layers of depth to the way that we can support members of our community.”

Opioid Agonist Treatment (OAT) provides patients with access to a prescribed opioid alternative, such as methadone or suboxone, to help manage substance use cravings and withdrawal symptoms. The medication is part of a larger treatment plan to help stabilize and support people so they can more effectively engage in therapy, counselling, and other aspects of recovery.

“What we’re trying to do is respond to the community’s need,” said Markham.

Specific information wasn’t available for the Robson Valley (McBride/Valemount Community Health Service Area), however, in July 2020, almost 1,000 opioid agonist prescriptions were dispensed in Northern Health.

An OAT clinic typically offers access to a range of health professionals trained to support people with addiction and mental health issues.

Research shows opioid treatment therapies save lives.

A paper published last year in the Society for the Study of Addiction revealed opioid interventions prevented 3,000 overdose deaths over a 20-month period in B.C. During the same time frame, nearly 2,200 people lost their lives in illicit drug overdoses.

Dr. Ray Markham, a family physician in the Valemount Health Clinic said an opioid agonist treatment clinic could offer an evolving range of services depending on the community’s need. /ROB SHEAR

“It’s not just about prescribing,” said Markham. “There is a whole bunch of crossover with complex chronic pain and mental health.”

A clinic could also provide social supports, physiotherapy, and therapeutic interventions for pain control, depending on the community’s needs, Markham said.

One-stop clinic
“It is super helpful to have a one-stop shop clinic,” said Maureen Davis, executive director of the Canadian Mental Health Association operations in Prince George. “Having a doctor, a nurse practitioner, a social worker, an addiction counselor, having access to all those different kinds of support means you’ve just broadened options for the clients.”

Central to OAT treatment is access to a safe drug supply.

In 2020, fentanyl or its analogues was detected in about 80 per cent of all illicit drug overdose deaths in the province. Fentanyl is 50 to 100 times more powerful than heroin. Cheap and easily available, illegal fentanyl is often mixed with other substances, usually without the end user’s awareness or consent.

Since 2012, fentanyl has been implicated in more than 330 deaths in Northern Health.

Northern Health has the highest rate of deaths per capita from illicit drug overdoses in the province. From June 2016 to August 2020, 1,803 fatal and non-fatal overdoses were reported in Northern Health emergency rooms and health clinics.

Currently, a couple doctors in the Robson Valley prescribe opioid agonist medications and limited mental health counselling is available in McBride and Valemount. The nearest OAT clinics are in Prince George or Kamloops.

Barriers to access
“If one area of the province has access within minutes, and the other has access in hours, that’s not equitable,” said Ed Staples, president of BC Rural Health Network, which advocates for improved health care in rural communities.

“We’re very, very, very long way from being able to meet the needs in some of the rural areas,” said Davis. “We still have very insufficient supply of treatment possibilities, even down south, much less trying to get them close to home.”

Another obstacle for rural residents is the lack of anonymity.

“Stigma is a real problem,” said Staples.

“People are perhaps reluctant to use help, because then they are identified,” said Dr. Harry Keyter, a family physician at the Valemount Health Centre.

Still, being able to access treatment close to home in a reasonable time is ideal, said Davis. “When someone is ready for treatment, saying to them, ‘Well, we’ll put you on a waitlist now.’ Often you’ve lost your chance.”

Not everyone needs treatment, but it can be necessary with opioid addiction, said Davis.

“The patient needs to be ready, like somebody who’s smoking when they’re ready to stop,” said Keyter. Then they need to be supported so their recovery is sustainable, he said.

“A lot of it is revolved around building supports and supportive relationships, to help people on their journey,” said Markham. “To have the connections with the healthcare system that get them the services that would be helpful.”

“That holistic approach is where we’re trying to go,” said Markham.

Fran Yanor / Local Journalism Initiative / [email protected]