PTSBC hosts webinar on supporting patients with addictions

A moralistic view of drugs aimed at punishment rather than support has shaped drug policy in Canada, said Sarah Foster, nurse manager at PHS Community Services Society in Vancouver, who recently addressed a well-attended webinar hosted by the Pharmacy Technician Society of B.C. (PTSBC). The non-profit organization offers primary care to many people residing in Vancouver’s Downtown Eastside and Inner Victoria, primarily supporting them with opioid agonist treatment (OAT). Foster has helped develop multiple innovative opioid addiction treatment programs in an effort to combat the ongoing overdose crisis, including iOAT (injectable opioid agonist treatment), TiOAT (tablet injectable opioid agonist treatment), fentanyl patches, Sufentanil, Fentora, and fentanyl powder. Read: A look back as the Canadian Association of Pharmacy Technicians turns 40 The focus is on harm reduction, an evidence-based client-centred approach that seeks to reduce the health and social harms associated with addiction and substance use, and provides people who use substances a choice of how they’ll minimize those harms through non-judgmental and non-coercive strategies in order to enhance their skills and knowledge to live safer and healthier lives. Harm reduction supports the idea that those with addiction and substance use issues should be treated with dignity and respect, and be empowered to make an informed decision about their individual needs and what will be most effective for them while also reducing harm. “With harm reduction, it’s really important to realize that not everyone is in a position to stop using drugs, and some people will never be able to stop using drugs, whether that’s due to chronic pain or just their life circumstances,” said Foster. “But using drugs shouldn’t be a death sentence.” Read: Taking the fear out of pharmacy assessments Harm reduction also encompasses such concepts as education, nicotine patches for smokers, drug treatment, counselling, medications like OAT, and housing—it’s hard for people to overcome their addiction when they’re living in poverty or on the street, said Foster. Often, people with substance abuse disorders have experienced multiple traumas. Trauma in pharmacare acknowledges the need to understand the patient’s entire life experience in order to deliver effective care. It shifts the focus from “what’s wrong with you” to “what’s happened to you?” Using a trauma-informed approach with patients means welcoming people to the space and making them feel respected and supported. “People need empathy; they don’t need pity,” said Foster. “They need understanding.” It is also important to remember that addiction is not a choice or a moral failing; it is a disease of the brain. While there are various options for supporting people with addiction, most are limited. There is often a wait to get into medical detox due to lack of space. There are not enough treatment and recovery clinics, and some are extremely expensive. Housing, employment, and counselling are badly needed. Medical interventions to support people with addictions primarily include OAT and methadone, but PHS has started several fentanyl patch programs in community pharmacies that Foster says have been successful for many patients. PHS has also worked with a compounding pharmacy to create fentanyl powder in colour-coded capsules with different strengths for use in two types of programs that have been highly successful as well. In response to a question, Foster said she hoped fentanyl powder would be available outside Vancouver and that there were two clinics in Ontario looking at starting their own fentanyl powder program. And while there are many harm-reduction programs in other parts of Canada, they don’t receive a lot of funding, so many are self-funded and volunteer-run. In closing, PTSBC host Bal Dhillon noted that “it is important for healthcare workers to better understand how and why some people may go down that path and what we can do to better educate ourselves.”

PTSBC hosts webinar on supporting patients with addictions

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