Methadone alternative Suboxone gets police chief's OK

Some addictions specialists continue to lobby the Nova Scotia government to approve a drug other than methadone for broader use, a move the Kentville police chief says would make the streets safer.

Kentville Police Chief Mark Mander says Suboxone, which comes in pill form, makes it less appealing to children.

"When you look at something in the liquid form that looks like a nice, neat bottle, kids might tend to get into that," he said.

Some doctors also see Suboxone as a safer option and have been lobbying the province to expand its criteria for coverage. The Department of Health and Wellness pays for Suboxone only if someone can't take methadone for health reasons.

"In a relative sense, it's safer than methadone," said Dr. David Saunders, who works with people recovering from substance abuse at Direction 180 in Halifax.

The active drug in Suboxone has "a ceiling effect" so it's less sedative than methadone, according to Saunders.

"Because of that, Suboxone on the street market is by no means as popular in Canada ... because it doesn't bring about the same effect that morphine or Dilaudid or those kind of opiates would," he said.

On average, it costs the province about 20 to 80 cents for a dose of methadone. Depending on the dose, Suboxone can be anywhere from $2.67 and $4.73 per day for a patient.

But Saunders said a patient can take a week or even up to a month of doses of Suboxone, which means fewer visits to the clinic. He said that could even out the price difference in the long run.

Timeline unknown

The province would not comment on when its review of the drug plan would be complete.

"Cost is a consideration but it's also the evidence and the health outcomes of patients that we also look at," said Judy McPhee, executive director of the province's pharmaceutical services.

"We're looking at the criteria as we do with most drugs after they've been on the formulary for any length of time. We do look at changing evidence and where the criteria may need to be expanded."

Mander said safety should be a priority.

"We shouldn't be looking at it from a financial perspective, we should be looking at it for what's going to work best for that person so they can get back on the employment stream," said Mander.

According to Nova Scotia's medical examiner there were 82 methadone-related deaths between 2008 and 2013. Methadone was listed as the single cause in about a quarter of those deaths. The other people died as a result of a combination of alcohol or drugs, as well as methadone.

"Even if Suboxone was approved for general use there would still be a significant number of people who would still need to be treated with methadone, so there's a place for both," said Saunders.

"But increased access to Suboxone would be beneficial."