May 10, 2018

Kwadacha, Tsay Keh Dene, and Gitxaala can now offer Suboxone Replacement Therapy

Cathy Zarchynski, FNHA Nursing Practice Consultant for substance use, has 20 years of nursing experience working with people who use substances. She began work at FNHA in November of last year and had never been to a remote FNHA Nursing Station until she visited the communities of Kwadacha and Tsay Keh Dene this past winter. She travelled there to support local nurses and build capacity to deliver Suboxone therapy.

Suboxone is a prescription medication that helps individuals who are dependent on prescription or illegal opioids by eliminating the cycle of withdrawal and craving for opioids. Suboxone supports people so that they can continue on their healing journeys.

Once Cathy had arrived in community, a two-day journey involving planes, ferry rides and trips down logging roads, she worked closely with community nurses, health partners, and community members to build processes and support nursing training. Together they resolved the challenges of delivering Suboxone in these very remote locations.

"It was a really new experience for me and it was not what I expected. It's amazing what the community nurses can do in a remote area with so few resources!" said Cathy. "To see it first hand was really life changing—personally and professionally. The experience was profound."

Community nurses received education and training in Suboxone delivery. Nurses did face-to-face education with Cathy, completed online addiction treatment training through UBC, and flew to Vancouver to do a two-day practicum at the Rapid Access Addiction Centre at St. Paul's Hospital in Vancouver.

"The hands-on clinical placement at St. Paul's was a valuable learning experience. The nurses worked with clients in withdrawal under the guidance of experienced nurses and doctors," explained Cathy.

Another key piece for successful Suboxone delivery is ensuring that the community has a doctor or prescriber who is ready and willing to treat patients with Suboxone therapy, which both communities had.

Finally, Cathy worked with FNHA Pharmacist Cindy Preston to get the supply of Suboxone and withdrawal support medications into the nursing stations, as these medications were new to the FNHA Nursing Station Formulary.

This past March, Cathy supported Suboxone delivery in Gitxaala near Prince Rupert, making it the third remote community to build this capacity. She provided similar support to the community there. This time around she also held a talking circle about substance use and healthy choices on the community's drumming night. The talking circle was well received and first responders, Elders, community members, and people in recovery participated.

Based on these successful Suboxone implementations, FNHA Nursing Services has begun to develop capacity in all eight of FNHA's remote nursing stations, so that those nursing stations are ready to provide seamless access to Suboxone therapy when communities request it.

What's next? FNHA Nursing Services plans to meet with each regional team to support their plans for addressing opiate use, access to Suboxone, and building local capacity.

The ferry Cathy took to Gitxaala.