People outside of Yellowknife who need the territory’s opioid maintenance program will have to make their way to the capital city to access it.
Dr. Jennifer Harris runs the program, which transitions people from illicit opioids such as fentanyl and heroin to less potent prescribed substances such as opioids methadone or suboxone.
In February, Yellowknifer reported a GNWT task group dealing with a rise in fentanyl overdoses had a goal to offer the therapy to communities. As of last week, Harris said the program is still limited to Yellowknife and there are no immediate plans to expand.
As it works now, people using the program make a daily visit to a pharmacy to ingest either the liquid methadone or pill-form suboxone under pharmacist supervision. Once the patient achieves a level of stability in their life, they can begin to take home several doses and may eventually only need to visit the pharmacy once a week.
Harris said the program has seen positive outcomes so far.
“We’ve seen lots of success stories,” she said. “Single parents that had lost custody of their children reacquiring custody, being able to achieve stable housing, moving into lots of success in terms of schooling and work.”
The program saw an initial spike in the number of participants four years ago when fentanyl first entered the drug supply. These days, an average of 20 to 30 people are enrolled at any one time.
Harris points out Ontario has a suboxone program in remote communities, but added expanding the program here would be a long process. In the meantime, Harris said she tries her best to assist anyone outside of Yellowknife needing this service.
“Whether it’s flying people in or getting people to drive in once a month and seeing if we can manage them in their home community,” she said. “At this point it would require their community have a pharmacy.”
Harris is also providing access to what she calls ‘opioid safety therapy,’ on a case by case basis to people outside Yellowknife. This therapy uses a long-acting form of morphine administered daily through the community’s local heath centre. Yet she said it is not an ideal solution.
“It’s very challenging for the health centres that are chronically understaffed and so that’s been really tough for them to handle,” she said.
Methadone and suboxone can only be dispensed by pharmacies in the territory for the time being, putting these therapies out of reach of smaller communities. Morphine, on the other hand, can be dispensed by any licenced doctor or nurse practitioner.
Harris said the next step towards expanding the maintenance program is a September meeting with Stanton Territorial Hospital to create a pathway of patients to the program, which Harris runs out of the Yellowknife Primary Care Centre.
Health department spokesperson Damien Healy stated in an e-mail the department hopes to create a group by the fall to examine the need for expansion of the program.
Other work being done by the NWT Opioid Misuse and Overdose Task Group include the placing of a survey card into all Naloxone kits in an effort to further understand how they are being used. The card is voluntary.