Career Development Member Resources-Addiction Medicine: A Canadian Perspective

Video Transcription

Video Summary

Dr. Paxson-Bach presented an overview of Canada’s response to the overdose crisis, with a focus on British Columbia’s innovative addiction medicine training, clinical care, harm reduction, and system redesign efforts. He opened by emphasizing the disproportionate overdose burden among Indigenous peoples in BC and described the broader national gap in addiction medicine education. In Canada, addiction medicine is still not a fully recognized specialty, and training opportunities for specialists remain limited. In contrast, his Vancouver-based program has expanded through online education, fellowships, and interdisciplinary training, leading to a major increase in opioid agonist treatment prescribers and patients receiving care.<br /><br />He then described the current drug supply as increasingly toxic and unpredictable, with fentanyl, benzodiazepines, stimulants, and emerging adulterants like xylazine and medetomidine complicating care. Drug checking programs and warning systems help monitor the supply, though their direct clinical impact is still being studied. He highlighted several harm reduction and treatment measures that have helped, including widespread naloxone distribution, supervised consumption sites, and opioid agonist treatment, while noting that these alone have not been sufficient.<br /><br />A major theme was the need for a more coordinated, patient-centered “continuum of care.” He described the Road to Recovery initiative, which links emergency care, withdrawal management, transitional housing, and treatment services under one coordinated system. Early results show faster access to detox, improved retention in treatment, higher patient and provider satisfaction, and strong 30-day retention on opioid agonist treatment. He concluded that the overdose crisis requires more ambitious, integrated, and evidence-based responses.

Keywords

overdose crisis

Canada

British Columbia

addiction medicine

harm reduction

opioid agonist treatment

fentanyl

naloxone

supervised consumption sites

drug checking

xylazine

medetomidine

continuum of care

Road to Recovery