Opioid roundtable brings key stakeholders together
The opioid epidemic is a pressing and tragic public health issue, with thousands of lives lost each year in Canada, and all the pain those losses mean to families and communities nationwide. On Nov. 30, the Public Policy Forum held a roundtable to advance policy discussions around pathways to treatment and recovery for opioid addiction.
Joanne Bezzubetz, The Royal’s President and CEO, moderated the roundtable discussion. Dr. Kim Corace, director of clinical programming and research at The Royal’s Substance Use and Concurrent Disorder Program, participated in the roundtable.
They were joined at the invite-only event by representatives of frontline health care providers from a variety of settings, peer support workers, federal government, Indigenous groups, public affairs, insurance providers, individuals and family members who have experienced addiction, and health care system advocates.
The Public Policy Forum is a non-partisan think tank “focused on building bridges among diverse participants in the policy-making process, and giving them a new platform to examine issues, offer new perspectives, and feed fresh ideas into policy discussions.”
Key points of the discussion include:
- Opioid addiction is not a single crisis. It represents many overlapping challenges.
- Addiction is ultimately a disease of despair. Suicide in the U.S. has increased 30 per cent in the last 10 years, and many opioid overdoses are suicides. These issues should be seen as related.
- The opioid epidemic stems in part from issues in how we treat pain – an issue in which policymakers, health care providers, and insurance providers play a role.
- Opioid-related deaths are often due to contaminated supply.
- The majority of opioid users are young men, and this isn’t being analyzed enough.
- Treatment often isn’t available promptly to the people who need it. We need to increase the availability of rapid-access addiction medicine, such as the clinics at The Royal, so that when people are ready to address their substance use concerns, help is there.
- The single biggest risk is using alone, and stigma and criminalization both play a role in people doing this.
- Supervised consumption sites are a key component of harm reduction, and they’re also proving to be important pathways to treatment.
- Recovery comes in many forms. It doesn’t always mean abstinence. Not everyone can stop using completely, but everyone has the potential for a better life.
- Health care providers are working within a fragmented system. There needs to be more cross-sectoral and inter-agency collaboration to ensure equitable access to all evidence-based treatments across the system and geography.
- There are few services for young people, which is unfortunate because this is a high-risk population. The Regional Opioid Intervention Service at The Royal has shown that services tailored to young people work well – we need to be doing more of this.
- More health care providers need to be trained in treating addiction. Many physicians, for example, don’t feel comfortable prescribing medication to support opioid addiction recovery. Issues like this reduce access to help.
- Indigenous people often face lack of access due to distance and cost, lack of culturally appropriate and safe care, and lack of access to non-pharmaceutical pain management. Substance use is a small part of a constellation of huge issues, including overall lack of access to high quality, appropriate care.
- The effective criminalization of opioid addiction puts people at increased risk. It makes people more likely to use alone. It disincentivizes digital communication surrounding opioid use. It increases the risk of contaminated supply. It reinforces stigma. It prevents people from getting help.
- Prevention needs to be a bigger focus – especially among youth. Building wellness and resilience among young people, especially those identified as being at risk for addiction, is a demonstrated way to reduce risk that isn’t being invested in.
- Hope comes from people with lived experience of addiction and recovery.
The Public Policy Forum will publish a full report, including key recommendations stemming from this discussion, in the near future. This report will be circulated among decision makers at federal and provincial levels.