Panelists Discuss Providing Opioid Agonist Therapies (OAT) at FNHA’s Inaugural Mental Wellness Summit



At FNHA's Mental Health and Wellness Summit a panel of four health leaders working in communities and in treatment centres hosted an informative discussion about delivering Suboxone to community members that choose this therapy as part of their healing journey.

Suboxone is a prescription drug that is classified as an 'opioid agonist'. It is prescribed for clients who are dependent on prescription or illegal opioids. Suboxone helps people with opioid withdrawal symptoms and blocks opioid receptors. Suboxone is covered by BC PharmaCare and First Nations Health Benefits.

All panelists strongly support using a harm reduction approach when working with people using substances. They emphasized the importance of providing clients the opportunity for self-determination and choice on their healing journeys – choices like Suboxone. And they all highlighted that working closely with community and health partners is a critical success factor in delivering Suboxone.

FNHA nurses Erin Wiltse and Cathy Zarchynski underlined that detox and abstinence are not realistic starting points for everyone. "Lots of options and harm reduction choices are important on the healing journey because no one way is the right way," said Cathy Zarchynski, Clinical Nurse Specialist – Addictions with FNHA.

But Suboxone therapy alone is not enough. Maintenance therapies like Suboxone work best when supported by a continuum of care. "Multiple strategies are needed to achieve spiritual, emotional, mental and physical healing," adds Cathy. Strategies like traditional healing, land-based healing, elder support, live-in or day substance use treatment, counseling, education, family and individual therapy, and support groups.

Delivering Suboxone requires substantial preparation. Marlene Isaac, Executive Director at Trout Lake Treatment Centre, talked about the realities of delivering OAT in a treatment centre setting, which includes consulting with doctors, developing policies, training staff, and understanding drug storage requirements.

"There are a lot of procedures and policies that need to be put in place to deliver Suboxone. Once they are in place, it's a smooth process," says Marlene.

Carol Eshkakogan, Executive Director of Benbowopka Treatment Centre in Ontario, talked about their multi-partner approach to integrating health services that are trauma-informed, including services for addiction.

"At Benbowopka, we have a well-established interdisciplinary and inter-organizational continuum of care, which provides wraparound services that are respectful and holistic," explains Carol.

The Centre has been operating successfully for 30 years and combines Aboriginal and Western healing practices.

FNHA is committed to providing Suboxone therapy to rural and remote communities and is working in partnership with communities that request it. Not all nurses work in addiction-focused roles, so FNHA has developed an extensive Suboxone Clinical Practice Guideline for them.

"With the guideline, we're training nurses to capture opportunities and provide access to Suboxone for clients in that moment," says Erin Wiltse, Nursing Practice Consultant with FNHA.