Hydromorphone: Is Controversial Addiction Treatment Saving Lives?

In the first episode of our series on addiction, Stu sat down with Colin Ross for a provocative conversation about his life and how hydromorphone treatments have given him new hope after years of addiction.

Since 2014, the BC Centre for Substance Use has provided this treatment to a select group of people dealing with addiction at the Crosstown Clinic on Vancouver’s Downtown Eastside—the first clinic to do so in North America.

Hydromorphone, sold under the brand name Dilaudid, is a synthetic opioid similar to heroin. Since trials began, it has changed many lives, including Colin’s.

Research Shows Injectable Treatments Work

Research conducted here in Vancouver reveals that prescription heroin and injectable hydromorphone can help stabilize people who are addicted.

Take a look at pieces of the research findings HERE.

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Provincial Government: Establish Guidelines 

The provincial government engaged the B.C. Centre on Substance Use to revise guidelines for the treatment of opioid addictions in order to include injectable options. BC will be the first region in North America to do so.

In October of this year, the Province of BC released guidelines for injectable opioid treatments. The guidelines are available from the BC Centre On Substance Use HERE. 

“In the midst of an epidemic of opioid overdoses, we need to give people who are struggling with addiction as many treatment options as we can so we can reduce the tragic number of deaths in communities across our province,” said Judy Darcy, Minister of Mental Health and Addictions. “Expanding access to additional treatments for opioid addiction like hydromorphone will help provide a wider range of supports for people with addiction across the continuum of care, from harm reduction through to recovery.”

In a release, BCCOS noted that the guidelines are grounded in the extensive international and Canadian research, including the NAOMI and SALOME studies conducted at Providence Health Care’s Crosstown Clinic, showing that hydromorphone and prescription heroin are both effective treatments for opioid addiction, providing both stability and health benefits to those who have not benefited with traditional oral treatments.

Health Canada recently lifted restrictions on the import of diacetylmorphine and other drugs to address overdoses.

Federal Drug Law Reform On Agenda

In early October, Dr. Evan Wood of the BC Centre for Substance Use sat down with Stu for a Conversation That Matters about the need for federal drug policy reform in order to substantially address the opioid crisis:

Continue the Dialogue

The BC Centre for Substance Use is actively working to educate the public about these treatments. Here are questions to consider. BCCSU provides their responses HERE.

  • Do patients require continually escalating doses of hydromorphone?
  • Should the public be concerned about iOAT programs causing security and public safety issues?
  • Why should my tax dollars go towards providing free iOAT?
  • Is this just giving people free drugs?
  • Will people accept hydromorphone or will they refuse anything but prescription heroin (diacetylmorphine)?
  • Why do we need this? Can’t people just take methadone or buprenorphine/naloxone?
  • Is the goal to transition people off hydromorphone as quickly as possible?
  • Was oral hydromorphone studied as well as injectable hydromorphone?
  • Aren’t you just substituting one drug for another?
  • If someone has experienced multiple overdoses are they a candidate for iOAT?
  • Is iOAT only for people who have tried oral OAT and not benefited?
  • Is injectable naltrexone an option for severe and/or treatment-refractory opioid use disorder?
  • Should it be tried before hydromorphone or diacetylmorphine?
  • What happens to patients on the program who are continuing to use fentanyl and other opioids on a regular basis?
  • What if patients want to attend for hydromorphone doses more often than three times per day?
  • If hydromorphone and prescription heroin are provided by the government, does that mean all drugs will be made available by the government?
  • Do patients ‘get high’ from the prescribed iOAT doses?

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