Vancouver Coastal Health (VCH) is implementing a guideline aimed at improving physicians’ knowledge of the medical and psychosocial treatments available for opioid addiction.

The guideline, developed by VCH, Providence Health Care, and representatives from the Ministry of Health, was peer reviewed by patient groups and local and international experts in the field. It supports a diverse array of possible treatments, including the use of buprenorphine/naloxone (Suboxone) as a preferred first-line treatment because buprenorphine is 6 times safer than methadone in terms of overdose risk and has a safer side effect profile. The guideline also recognizes that most individuals will benefit from the ability to move between treatments and highlights the role of support recovery programs, stressing that there is substantial potential to improve treatment for opioid addiction while reducing the burden of disease and the health and social costs associated with untreated addiction.

Dr Evan Wood, medical director of community addiction services at VCH, suggests that opioid use disorder is one of the most challenging forms of addiction facing the health care system in BC and points out that while methadone is a highly effective treatment approach, not all patients need it and there are challenges involved with its use. Instead, physicians are encouraged to start with the least toxic, most effective approach and proceed from there when necessary.

The guideline is available to physicians on the Vancouver Coastal Health website [8].