Written by Jessica Cadoch
Oxycodone, Codeine, Morphine and Heroin are all classified opiates. These substances are procedurally offered by medical experts as painkillers and seek to relieve patients from deep suffering.
However, these substances are also highly addictive, and there is no thorough protocol to get patients off these substances once their prescription runs out. As a result, thousands of patients grow reliant on these medicines. Often, These individuals turn to illicitly-obtained opiates to support their increasing dependence on prescription medications. These alternatives include synthetically manufactured substances, some of which are up to thousands of times more potent than commonly-prescribed opioids. North America’s deadly opioid crisis has dominated countless news headlines over the past few years, but maybe you didn’t know precisely where it was born.
Advertised as the first ‘minimally addictive’ opioid, OxyContin (manufactured by Purdue Pharmaceuticals) managed to surpass heroin abuse rates in 2004. By 2010, prescription opiates “became the most abused class of substances among US high school seniors (National Institute of Drug Abuse [NIDA] 2011)… Purdue Pharmaceutical paid $634 million in fines for criminal charges based on misrepresentation of Oxycontin’s addictive potential (Van Zee 2009)”.
In the last six months, in the face of the COVID-19 pandemic, we have seen a dramatic spike in opioid overdoses, adding more layers of destruction and devastation on an already isolated, uncertain, and grieving society due to the distancing measures, deaths and job losses that hallmarked this pandemic.
What is happening with opioid misuse in Canada?
Due to a culmination of factors that include closed borders, a subsequent dip in supply and a lack of availability to clean substances, opiate overdoses in Canada increased drastically during COVID-19 isolation mandates.
Ontario has reported a 25% rise in fatal overdoses. A severe spike in opioid-related deaths prompts warning that carfentanil, an analogue of the synthetic opioid, fentanyl, is present in Edmonton’s street drugs, and is reportedly 100 times more potent than fentanyl, 5,000 times more potent than heroin and 10,000 times more potent than morphine.
“We now know that carfentanil is circulating. It’s in injectables and smokables, both up and down. Don’t use alone, have naloxone nearby, use a fraction of your usual dose.” – StreetworksAB
Alberta’s EMS teams have responded to the spike in opioid use calls since the COVID-19 pandemic. Furthermore, after serious efforts to implement SIS (safe injections sites) in British Columbia, with a 39% increase in overdose deaths in April alone, they are bearing witness to a resurgence in the opioid crisis. Finally, in the Yukon, opioid-related overdoses have doubled in the last year. Unsurprisingly, Canada’s Chief Public Health Officer, Dr. Theresa Tam calls the current crisis an “increasing concern” and an “unintended negative consequence” from the pandemic response.
Canada’s opioid response options
Journalist and addiction specialist Johann Hari famously noted that the opposite of addiction is not sobriety, but connection.
Over the past 20 years, alongside the opioid crisis, there has been a resurgence in interest in researching the healing potentials of psychedelic substances such as MDMA, Psilocybin, and DMT to treat Addiction, PTSD, Depression, and end-of-life distress.
Upon quantifying a mystical experience and developing the Mystical Experiences Questionnaire, researchers at Johns Hopkins University, including Dr. Roland Griffiths, Dr. Matthew Johnson and Dr. Katherine MacLean, noted that psychedelic substances foster feelings of connection to others, nature, and the self.
Before the creation of this questionnaire, in 1960, philosopher Walter Stace examined the qualities of a mystical experience, noting that “the core experience of unity was “the essence of all mystical experience” (Stace 1960:132)” (MacLean et al. 2012, 722).
Suppose substance use disorders stem partly from a loss of connection to self and community, as Hari notes, and psychedelic substances can foster these feelings of attachment to others, nature and self. Why then is psychedelic-assisted therapy for the treatment of addiction not more widely available for the treatment of addiction?
Bringing psychedelic substances into the world of Western Biomedicine is a long and slow endeavour. Many researchers are pooling their efforts towards making psychedelic-assisted therapy more accessible to those suffering from substance misuse.
Entheon Biomedical believes that it is time that the narrative around psychedelic-assisted therapy takes a sharp turn away from the stigma. We are committed to the legal development of safe & effective psychedelic medicines, particularly DMT. DMT, the active ingredient in ayahuasca, is a psychedelic that is traditionally used in spiritual practices by indigenous communities of the Amazon basin. Our researchers are confident that DMT can be beneficial to those who are dependent on harmful substances.
Contrary to other psychedelic substances undergoing FDA clinical trials in the US, DMT’s psychedelic onset is typically very rapid and intense, beginning within two minutes. Isolating DMT could result in a drug that delivers a much shorter psychedelic experience than the four to eight-hour type a patient would expect with ayahuasca, psilocybin, or MDMA.
A shorter experience could open up psychedelic-assisted treatment to more people at a fraction of the cost. One of the issues at the forefront of clinical trials and expanded access programs for psychedelic-assisted therapy is the financial accessibility of this therapy. Psychedelic-assisted therapy sessions with MDMA or with psilocybin-containing mushrooms last anywhere between 4-7 hours. Within these protocols, it is mandatory to have two therapists present during the therapy session. To compensate two therapists for 4-7 hours is a costly endeavour.
By isolating DMT, it may be possible to achieve shorter-lasting psychedelic experiences, which could lessen the length of psychedelic-assisted therapy sessions without diminishing efficacy. By shortening a patient’s time in the clinic, we would undoubtedly minimize the cost of this safe, effective, yet challenging to access therapy. With the opioid crisis worsening in Canada and beyond, we grow even more hopeful that Entheon Biomedical’s findings will help lay the groundwork for a more effective and compassionate treatment for substance use disorder.
“Having lost my brother to opiate addiction, I can attest to the devastation and chaos brought on by opiate use. As the lethality of these substances rises, the efficacy of currently available treatments remains unchanged, and hundreds of lives are lost each month in British Columbia alone. There should be an acceleration of efforts to provide new solutions rooted in a better understanding of the causes of addiction.” —Timothy Ko, Entheon CEO