Alberta’s government will be offering high-potency opioids in clinical settings, and in a first among Canadian provinces will regulate the use of psychedelics in therapy treatment.
On Wednesday, the province announced amendments to the Mental Health Services Protection Act, which allows certain opioids to be prescribed to patients with severe opioid addiction who have not been able to initiate or stabilize on conventional opioid agonist therapy (OAT) treatment.
“Alberta’s government is taking bold action to protect our communities fromdiversion of dangerous opioids, while also improving access to narcotictransition services for people with severe opioid addiction,” said Mike Ellis, associate minister of mental health and addictions.
“The community protection and opioid stewardship standards are a first oftheir kind. It’s a first of their kind in Canada that will improve the way opioidsare used to treat addiction.”
Opioids such as hydromorphone, diacetylmorphine (heroin) and fentanyl will be offered at licensed Opioid Dependency Program (OPD) clinics run by Alberta Health Services (AHS) in a new narcotics transition program.
The changes mean pharmacists and other dispensers will no longer be able to dispense high-potency opioids for addiction treatment.
The drugs will only be administered at an ODP clinic, where the patient will be under supervision and the narcotics cannot leave the clinic. The goal is to transition the patient to OAT medication, like Suboxone, Sublocade or methadone, and provide access to other wraparound supports.
However, a patient cannot be discharged from the program if they are unable to make the transition.
A portion of the class-action settlement against opioid manufacturer Purdue Pharma awarded to Alberta will be used to fund the narcotic transition services, Ellis said.
Dr. Nathaniel Day, medical director of the Virtual Opioid Dependency Program, said the program has new spaces and new resources to provide care to people that have not been able to access it in the past.
“We’re actually increasing access to this service across the province. This is not just an Edmonton clinic issue or a Calgary clinic issue,” he said. “We are going to have the opportunity for NTS services to be available in every zone of this province, care that has never been offered before. So I think that full stop we need to recognize that this is an effort to make this more accessible.”
The province is also requiring primary care providers who have already been treating patients for opioid addiction with high-potency opioids to transition their patients to conventional OAT medications or transfer them to an OPD clinic.
Narcotic transition services will be available immediately at OPD clinics in Edmonton and Calgary, while the program is expected to expand to clinics in Lethbridge, Medicine Hat, Red Deer and Grande Prairie in the coming months.
It is estimated fewer than 350 patients will be affected, and patients must be transitioned to OAT or a licensed clinic by March 4, 2023. Patients who are prescribed opioids for chronic pain or other illnesses will not be affected by these changes.
The province also announced plans to regulate the use of psychedelics, such as psilocybin, psilocin, MDMA, LSD, mescaline (peyote), DMT, 5 methoxy DMT and ketamine, to treat psychiatric disorders. The regulations for psychedelics will come into effect on Jan. 16, 2023.
According to the provincial government, emerging evidence has shown that psychedelic-assisted therapy can lead to improvements for people with certain psychiatric disorders, such as PTSD. As psychedelic drugs carry health and safety risks, the new regulations are meant to provide safeguards and expert medical oversight.
The regulations for psychedelic drug treatment differ based on the level of risk involved. With few exceptions, clinics offering psychedelic-assisted treatment must be licensed and have the medical oversight of a psychiatrist.
“Some of the strongest supporters are among first responders and veterans whosuffer from high rates of PTSD and other mental health conditions,” said Ellis.“As a former police officer myself, I want to ensure that if there are promisingpractices to make life better for people with these conditions that we aresupporting them in a professional way.”