Alberta to continue iOAT program for existing clients under $6M grant

Alberta says it will continue to fund injectable opioid agonist treatment (iOAT) for current patients under a two-year grant.

It comes as the government faces a lawsuit brought by 11 patients who say Alberta's move to end funding for the life-saving program is a violation of their Charter rights. 

Staff were told about the grant in a conference call on Tuesday morning, two AHS employees with knowledge of the iOAT program told CBC News. 

CBC is not naming the two AHS employees because they were not authorized to speak publicly about the grant.

With the $6-million, two-year grant, iOAT clients are expected to receive the same level of care when they are transferred to opioid dependency programs, the employees said.

"The name iOAT is disappearing at the end of March, the program and services continue with no change," an AHS employee said. 

There are 88 patients in the iOAT program, 44 in Edmonton and 44 in Calgary, according to AHS. But no new patients will be accepted, spokesperson Kerry Williamson confirmed. 

Shane Monette, one of the plaintiffs, said he was relieved to learn about the funding decision.

"Today is a very good day and I feel like a lot has been accomplished," he said. 

"It's been a nightmare not knowing whether or not it's going to close or open," he said.  "We're talking about the difference between life and death here."

Injectable hydromorphone is considered a last-resort treatment option for people with severe opioid addictions when oral-based options offered at opioid dependency programs, such as methadone, prove ineffective.

Patients started to disengage from the program after the government announced last March it would end the program, according to an affidavit from Dr. Krishna Balachandra filed in the lawsuit. One patient died after being discharged, he said. 

After the lawsuit was filed, government lawyers announced the province would continue to offer existing iOAT clients with hydromorphone. But despite the name, injectable treatment is just one aspect of iOAT — and questions remained about the continued availability of other wraparound services. 

It's been a nightmare not knowing whether or not it's going to close or open.- Scott Monette, iOAT client and lawsuit plaintiff

The judge found some primary care treatment would not be available to clients transferred to the opioid dependency program clinic, with referrals offered instead. Court documents show some clients feared it could limit care for lung and blood disorders and HIV, among other conditions. 

The judge also said the level of psychosocial support, from trauma therapy to housing services, would be reduced at opioid dependency clinics

But in dismissing the plaintiffs' injunction application last Thursday, Court of Queen's Bench Justice Grant Dunlop said the impacts would be "minor". 

No job losses, AHS says

Avnish Nanda, the clients' lawyer, filed an appeal yesterday. But he said Tuesday's announcement helped to end a year of government-generated uncertainty. 

"If there's one thing that the government takes away from this, it's that the lives of people who use drugs, people who live with opioid use disorder matter," he said. "And that other Albertans will fight and organize to ensure that they receive the type of treatment, the type of care that they need to continue to live."

In a statement, the press secretary for Associate Minister of Mental Health and Addictions Kassandra Kitz said the government "always said that these individuals in iOAT would not be cut off from programming." 

"In fact, the Government committed to support these clients before the court case, during the court case, and after it was completed," she said. 

The government revealed its plan to provide existing iOAT patients with hydromorphone through its lawyer after the lawsuit was filed — six months after it announced iOAT was set to close. 

The opioid dependency program in Edmonton will move into the current iOAT clinic, AHS said. While iOAT services in Calgary will continue to be offered at the Sheldon Chumir Centre.

Williamson, AHS spokesperson, said no clients have been transferred yet, as timing and planning is underway. There will be no job losses due to the transition. 

The iOAT program was first launched as a two-year, $14-million pilot by the NDP government in 2018. The Alberta government announced last March it would extend funding for a year to provide time for patients to be transferred into other programs. 

Last year marked the most deadly year for overdoses in Alberta on record, with data up to the end of November showing 997 people had died.