A timeline of British Columbia’s opioid-substitution program

A timeline of B.C.'s opioid-substitution program

VANCOUVER — British Columbia is the birthplace of methadone maintenance treatment, which has existed in some form in the province for more than half a century. Here is a timeline on how the treatment has evolved over the years:

1959: The world’s first methadone maintenance treatment program is introduced by a pair of physicians in Vancouver.

1960s: Health-care providers in B.C. begin to offer withdrawal management services as a formal treatment for opioid addiction as a growing number of patients become dependent on the highly addictive drugs.

1980s and 1990s: The federal government begins transferring authority to the provinces for the administration and regulation of methadone maintenance therapy programs. There is growing evidence showing the effectiveness of the treatment.

1996: B.C. launches the methadone maintenance program, giving the province’s college of physicians and surgeons responsibility for administering the initiative.

2006: The program balloons compared to its inception 10 years earlier, with the number of active prescribing physicians rising from 238 to 327, the number of dispensing pharmacies expanding from 131 to 482 and the number of clients jumping from 2,827 to 9,601, then to nearly 14,000 in 2012.

2014: Generic methadone is phased out of the provincial treatment program in favour of Methadose, a highly concentrated, brand name alternative. The switch prompts complaints from patients, whose requests for input into the policy move had been rebuffed, including that the new medication is metabolized more quickly, meaning a faster onset of withdrawal symptoms.

2016: All B.C. physicians are authorized to prescribe Suboxone, a combination of buprenorphine and naloxone, and which is considered a safer and more effective alternative to methadone.

2017: The newly created B.C. Centre on Substance Use releases new guidelines for treating people with opioid dependence, marking a shift away from the college of physicians and surgeons as the body responsible for development treatment protocols. The move also shifts focus from methadone to Suboxone as the treatment of choice.

SOURCES: Patients Helping Patients Understand Opioid-Substitution Therapy; Methadone Maintenance Treatment in British Columbia, 1996-2008; B.C.’s change in methadone formulation: A metanarrative review of the literature; Centre for Addictions Research of B.C.

The Canadian Press

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