Addressing fentanyl use disorder with fentanyl-assisted treatment

Abstract

The opioid overdose crisis has evolved into one of the worst public health emergencies in North America, with mortality rates having skyrocketed since 2015. 1 Ahmad F Rossen L Sutton P Provisional drug overdose death counts. National Center for Health Statistics. https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htmDate: 2021 Date accessed: September 12, 2021 Google Scholar , 2 British Columbia Coroners ServiceIllicit Drug Toxicity Deaths in BC. Jan 1, 2011–April 30, 2021. https://www2.gov.bc.ca/assets/gov/birth-adoption-death-marriage-and-divorce/deaths/coroners-service/statistical/illicit-drug.pdfDate accessed: September 29, 2021 Google Scholar The current political and public health responses have not done much to change the trajectory of the crisis. Moreover, neither the free distribution of psychotropic substances in a non-therapeutic context (safe supply), nor the available opioid agonist treatments (OAT), which are largely based on buprenorphine as first-line medication, have helped slow down the accumulating death toll. 3 Krausz RM Wong JSH Westenberg JN Choi F Schütz CG Jang KL Canada's response to the dual public health crises: a cautionary tale. Can J Psychiatry. 2021; 66: 349-353 Crossref PubMed Scopus (2) Google Scholar A similar critical situation is also unfolding in two Baltic states, Lithuania and Latvia. 4 Krausz RM Westenberg JN Ziafat K The opioid overdose crisis as a global health challenge. Curr Opin Psychiatry. 2021; 34: 405-412 Crossref PubMed Scopus (13) Google Scholar This crisis is having a direct effect on life expectancy, and is challenging the field of psychiatry, which is failing in the treatment of substance use and concurrent disorders. 5 Ye X Sutherland J Henry B Tyndall M Kendall PRW At a glance – impact of drug overdose-related deaths on life expectancy at birth in British Columbia. Health Promot Chronic Dis Prev Can. 2018; 38: 248-251 Crossref PubMed Scopus (39) Google Scholar