Another front in the drug-addiction battle opens at Siloam Mission

Winnipeg Free Press

7 days ago

A four-litre jug of orange juice and a stack of tiny cups are the signs that Siloam Mission has just wrapped up the second day of providing a life-saving treatment for drug addiction on Thursday.
The juice dilutes methadone, one form of opioid agonist therapy — a treatment for addiction to opioids including heroin, fentanyl and oxycodone. It involves taking medication, such as methodone and Suboxone, that reduces withdrawal symptoms for 24 to 36 hours.
It is the current standard of front-line care for opioid use disorder in Manitoba. It can be used short term or for several years and doesn't get the patient high. The Canadian Centre for Substance Use and Addiction says it reduces the risk of overdose, alcohol-related deaths, suicide, cancer and other illnesses because it increases a person's access to overall medical care and improves the chance of early intervention and treatment.
MIKE DEAL / FREE PRESS
Kris Allen Pharmacist at 432 Health Group talks about the on-site opioid agonist treatment (OAT) which the group will be providing medical supplies for.
'This would be for folks who are looking to be sober,' Tobi Jolly, Siloam's interim director of community wellness, said at the medical centre at Siloam.
'Withdrawal can be very dangerous for folks. Detox has a long waiting list here in Winnipeg, so if they're trying to do that on their own, it's just super unsafe for them.'
The program, which began at Siloam's Saul Sair Health Centre at 300 Princess St. on Wednesday, is scheduled to operate seven days a week from 9 a.m. to 12 p.m.
It was started following multiple instances in which people who wanted to be sober were unable to access timely resources, forcing them to continue using opioids, Jolly said.
'It's long waiting lists everywhere they go, (and) this is where a lot of our community members feel safe and comfortable,' she said.
A nurse practitioner, who can diagnose opioid use disorder and offer counselling, will be on site several days a week. A pharmacist will be on hand each day to administer the medication, which can't be taken home.
Patients' treatment will be recorded and tracked.
The pharmacist and nurse are employed by 432 Health Group, a Winnipeg company that offers a range of medical services. Last year, the firm asked Siloam how it could help, and staff overwhelmingly requested opioid agonist therapy resources.
In the first two days, five patients were treated, but staff expect word to spread quickly and more people to show up.
'Withdrawal can be very dangerous for folks. Detox has a long waiting list here in Winnipeg, so if they're trying to do that on their own, it's just super unsafe for them.'–Tobi Jolly
'We're building it,' said Kris Allen, a pharmacist with 432 Health Group. 'As new needs come to us, we're going to fill those gaps.'
In Manitoba, 320 nurses and doctors are approved to prescribe opioid agonist therapy. Some are out of reach for the people Siloam serves because many don't have health cards and aren't able or willing to leave the neighbourhood on a daily basis, Jolly said.
Manitoba's seven Rapid Access to Addictions Medicine clinics, which are run by the provincial government and provide urgent addictions treatments, including opioid agonist therapy, have long lineups and are, at times, forced to turn people away. Quitting 'cold turkey' is not just painful, but can put the person at a higher risk of overdose and death.
While the proposed supervised consumption site would be a crucial complement to Manitoba's harm reduction framework, Jolly said Siloam's new program is meant to intervene immediately if a patient is ready today.
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'A lot of solutions that are long term, they're going to take a while to happen,' she said. 'More detox beds and more treatment are a long ways away.'
The supervised consumption site plan is in the 'review stage,' as per Health Canada's website, which notes it is 'awaiting key information before decision can be taken.' The provincial government submitted its application in November 2024.
The College of Physicians and Surgeons of Manitoba removed some post-training requirements for a doctor to be able to prescribe Suboxone in 2023 in an effort to increase access to care.
Since then, there's been an uptick in the number of doctors providing the treatment, but there's demand for more, said Dr. Marina Reinecke, an addictions medicine physician and consultant for the college's prescribing practices program.
MIKE DEAL / FREE PRESS
Allen and Tobi Jolly, Interim Director of Community Wellness at Siloam Mission.
'(It's) certainly not what we would consider adequate access or easy access for most patients,' she said. 'We still have a long way to go in terms of developing those services, but things have improved a lot.'
While it is the standard of care, opioid agonist therapy is considered higher-barrier to some and works best in conjunction with other treatment, Reinecke said.
'Safe consumption sites are low barrier. We need them for overdose prevention and as an access point,' she said. 'Opioid agonist therapy is one of the more intensive therapies that people who use safe consumption sites can then sort of graduate into.'
Shared Health said in an email it's 'excited' another opioid agonist treatment provider is operating in Winnipeg.
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Malak AbasReporter
Malak Abas is a city reporter at the Free Press. Born and raised in Winnipeg's North End, she led the campus paper at the University of Manitoba before joining the Free Press in 2020. Read more about Malak.
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