September 11, 2018
Dr. Nathaniel Day is medical lead of the Alberta Health Services Rural Opioid Dependency Program.
Story by Dr. Nathaniel Day
Dr. Nathaniel Day is the medical lead of the Alberta Health Services Rural Opioid Dependency Program, and a member of the Minister’s Opioid Emergency Response Commission. Here, he speaks about the positive difference the program made in the life of one desperate Alberta man.
I just started a young father on medication to combat his fentanyl addiction.
He was desperate. His skin felt as if it were crawling. His muscles were so weak he could barely stand.
“We can help you,” I said. “And you’ll start feeling better as early as today.”
The 31-year-old — we’ll call him Mark — became addicted to opioids after a co-worker gave him some Percocets to help the work-related shoulder pain he was experiencing while employed at a remote jobsite. The pills helped ease the physical pain. They also made Mark forget about the loneliness of being away from his family. Soon he realized he needed more Percocets to get that same welcome, numbing feeling.
For six years Mark made multiple attempts to get off the drug. Each time he was shocked by the enormity of the physical sickness of withdrawal, and the feelings that overwhelmed him — including a complete lack of control: he had to have more opioids, and eventually ended up finding them on the streets.
“I was hanging on for dear life,” said Mark.
He had been searching for help, but wondered how he could go for treatment when he also needed to work. The mortgage payment was already overdue. And Mark’s family needed him; he couldn’t let them down another time — they were the main reason he was still alive.
“I want to become the kind of father that my kids can look up to,” Mark said.
Fortunately Mark spoke with someone who knew about the Alberta Health Services (AHS) Rural Opioid Dependency Program. He was started on medication treatment the same day he called.
When clients call and are registered in the program, they receive medication to replace the opioids. The medication provides what their body is missing but it doesn’t produce a high like the other drugs — so people can work safely and get their lives back. They also have regular video follow-ups with myself and other members of the team at local AHS addiction and mental health sites to monitor how things are going. Social supports are available for anyone struggling, but the vast majority of people report a positive change.
After earlier being drenched in sweat and shaky on his legs, within hours of starting treatment, Mark was up and doing chores around the house.
“I can’t believe how normal I feel,” he told me.
The Rural Opioid Dependency Program facilitates medication management that works with employment and location. The program works around a client’s life — not the other way around.
Mark can now think beyond survival, hold down a job on a service rig, provide for his family, and start working towards his future.
Once opioid replacement medication is in place, clients like Mark can get counselling. This portion of their recovery — whether through AHS addiction and mental health clinics, 12-step meetings, or their spiritual community — links them to healthier coping strategies to deal with stress and trauma. Addiction is a disease of loneliness and isolation; ending the isolation is critical.
Getting back to life is the final step. Waking up with purpose, and getting busy with work, family and other activities can replace the void opioids made in their lives. We want them to think about who they want to be and how they want to become that person.
Every day, two people die in Alberta from opioid overdose. Thankfully Mark is not one of them.
“I dreamed that one day I would wake up and not feel sick.” Mark said. “This program has changed my life. I am so thankful that I can be a father again.”
Have you been using opioids and want help to get off of them? Call 1-844-383-7688 in rural Alberta, including Red Deer, or visit drugsafe.ca to get help.
What are opioids?
Opioids are prescribed medication used to relieve moderate to severe pain. They include codeine, hydrocodone, oxycodone, heroin and fentanyl. They can be addictive and cause withdrawal symptoms when discontinued.
What is the Rural Opioid Dependency Program (RODP)?
Under the supervision of a healthcare professional such as a pharmacist, or unsupervised at home, clients take their medication, which replaces opioids and eliminates withdrawal symptoms and reduces cravings. A physician and other members of the healthcare team then do regular visits through videoconferencing. Visits are free, and medication is typically covered through Alberta Blue Cross or other private plans. Emergency coverage is available as well.
How long are people on the program?
The length of time depends on the individual treatment plan. Many people are able to successfully transition off of medications, while others remain on medications longer term depending on their needs. Medical evidence supports staying in treatment for at least one year.
How does this differ from inpatient treatment?
Opioid dependency treatment is medication-based treatment that reduces cravings and prevents withdrawal. Inpatient treatment is when a person moves into a centre for several days or weeks to stop using drugs or alcohol and start counselling to avoid returning to their former pattern of using.
What communities are served by the Rural Opioid Dependency Program (RODP)?
Most Alberta communities have access to an opioid dependency program (ODP). Based in the Central Zone, this program has clients in more than 60 communities across rural and suburban Alberta from small communities to larger centres such as Red Deer.
Contacts:
RODP: 1-844-383-7688 Toll-free
Calgary ODP: 403-297-5118
Edmonton ODP: 780-422-1302
Cardston ODP: 403-653-5283
Fort McMurray ODP: 780-793-8300
High Prairie ODP: 780-536-2136
Grande Prairie ODP: 780-833-4991
Bonnyville ODP: 780-826-8034
Or contact Health Link at 811, the Addiction Help Line at 1-866-332-2322 or drugsafe.ca for information.
