Why this rural N.S. doctor opened a clinic to treat opioid addiction

When Dr. Andrew Blackadar decided to open a clinic in response to rising opioid abuse in rural Nova Scotia, he settled on what might seem like a surprising location for it: his family practice in Liverpool, N.S.

Seven years later, he's still happy with the decision.

"In some ways, it's nice to run it out of a family practice because there's less stigma or barriers for access. People feel more comfortable in going to a place where folks wouldn't know why they were in the waiting room," Blackadar told CBC's Information Morning.

The clinic provides opioid-dependent patients with prescription replacement drugs that allow them to stop using dangerous street drugs while managing the symptoms of their addiction.

Opioid replacement drugs like methadone and Suboxone reduce withdrawal symptoms without providing the high of drugs like heroin or fentanyl.

As of Aug. 1, there have been 21 confirmed and 12 probable opioid toxicity deaths in the province this year.

Blackadar said limited access to treatment in rural areas like the South Shore means the clinic has seen patients from as far away as Shelburne, Caledonia and Lunenburg.

He said before his clinic opened, he had several patients making the trek from the South Shore to the Annapolis Valley for treatment. The hardship of having to travel back and forth meant they often experienced gaps in their care.

Blackadar said he wasn't sure what kind of reception the clinic would get, but he and addictions counsellor Dominique Kwan forged ahead.

"We started small, not quite realizing the need that was in the community, and things grew from there," he said.

Seven years on, the clinic serves around 75 regular patients. Blackadar said opioid dependency cuts across all socieconomic levels.

"I have yet to meet a patient who starting out using opiates [who] felt that they would ever have a significant problem," he said.

Blackadar said stigma and bias within both society and the medical profession have negatively affected access to life-saving treatment for opioid addiction.

'Very gratifying work'

He said the success rate of people trying to stop cold turkey or detoxing without opiate replacement is low.

"This treatment option offers them a way to get their lives back together," said Blackadar.

Blackadar said supplying patients with the replacement drugs allows them to avoid incarceration and stabilize their family and work life.

"Things have become exceptionally difficult in their lives, and over time they often do exceptionally well, so it's very gratifying work," he said.

Fewer ER patients seeking opioid access

Blackadar also works in the local emergency room. He said he's seeing fewer people seeking opioid prescriptions than he did prior to opening his clinic.

"At this point, that's fairly uncommon in our emergency room, I think mainly because most of the folks in our community who require this kind of treatment have been reached," he said.