Canada Lagging Behind on Addiction Therapies

Patients Missing Out on New Drugs, Treatment for Opioid Dependence:
Expert

TORONTO - Compared with other industrialized countries, Canada has
fewer pharmacological resources available for the treatment of
addictions, says Dr. Peter Selby, clinical director of the addictions
program at Toronto's Centre for Addiction and Mental Health (CAMH).

"We lost out on all the research that has shown addiction to be a
brain disorder and on regulatory issues for bringing those (types of)
products to market."

There has also been a reduction in the number of drugs to treat
addictions in the last 10 years, Dr. Selby said. "Clearly, our
strategy in Canada has not been to stimulate pharmaceutical companies
to develop their products for the treatment of addictions."

For opioid dependence, for instance, Canada is "lagging behind" in the
approval of buprenorphine, he said.

"At the recent American Society of Addiction Medicine meeting, where
they had a symposium on buprenorphine around the world, almost every
country was represented except Canada. . . . Health Canada has been
dragging its feet on this for too long."

Canada has typically taken a population-based approach to the
treatment of addiction. "That is a good thing, but you also need to
have clinical services and clinical kinds of treatment."

In Canada, CAMH has been attempting to address issues of
co-morbidity.

"One of our strategic areas is what is known as 'concurrent disorder
capacity building,' which is helping the mental health field develop
understanding and address addiction issues, and vice versa, and
(helping caregivers) understand that these are not mutually exclusive
conditions," Dr. Selby said.

Commenting on the high U.S. statistics on abuse of prescription drugs,
he said CAMH is currently looking at the data, but reported a
"substantial number" who are addicted to OxyContin.

"What we get is just a tip of the iceberg, and we're quite convinced
there are a whole bunch of people out there who are not seeking
treatment," Dr. Selby said.

Methadone Program

"Where we have a lot of evidence, and good evidence that we've made a
huge dent in the problem in Ontario, including death, is the (Ontario)
Methadone Program."

The program has been a "resounding success" and is an example of
quality control, Dr. Selby said. "Overall the death (rate) is much
lower than it's ever been, and (the program) has transformed many
people's lives."