Patients fighting drug addiction say they need more than medication to recover
Doctor says counselling, strong support network, housing are also necessary
Sitting inside a clinic in Vancouver's Downtown Eastside, Stan Kozicki is waiting to see his doctor for a methadone refill.
The former stone mason says he's been trying to recover from his opioid addiction for years but it's "not really" working.
Kozicki is among the more-than 30,000 British Columbians undergoing opioid agonist therapy (OAT), a medically assisted form of treatment for people with opioid use disorder.
Doctors prescribe drugs like methadone or suboxone, which help patients minimize withdrawal symptoms, find stability and work toward recovery.
In June, the B.C. government expanded access to OAT medications for anyone with MSP coverage — but the move made little difference to Kozicki, who says there are other supports that would help him more.
This includes the right mix of medications to meet his withdrawal needs, for example. Kozicki says his addiction has intensified over the years, shifting with the toxic drugs flooding the streets.
"It's quite hard to get off of it because it's fentanyl now. It's not heroin," he says. "It's a lot stronger of a drug to get off of — I've tried."
Kozicki receives prescriptions of hydromorphone pills, a form of safer supply, but he wishes he had double the dosage to offset the fast-acting, intense lure of fentanyl.
His doctor empathizes with Kozicki's struggle with OAT.
"I think that the tools I have right now fall short for a lot of patients," says Dr. Jay Wortman, medical director of Pacific Oak Clinic.
Wortman says the treatment was probably more effective before fentanyl became common and heroin, a weaker opioid, was the primary concern.
Kozicki also points to the need for housing options, which would include health-support workers and other services to address the needs of people struggling with addiction.
"Everybody in my building uses it because I live right on Hastings, everybody in my building uses," he said.
"It's hard to get away. I have to get out of this area to do it."
Kass or Kassandra, who only goes by her first name, is also a patient of Wortman's and lives in the Downtown Eastside. She says she shares Kozicki's concerns.
She says she's "stuck in a rut," and while the medications are helping to provide her more stability, her recovery journey is stunted by the lack of housing options outside the DTES.
"'Cause all your friends are addicts, you're an addict," she said, during a visit to Pacific Oak Clinic. "If you're with people who are doing dope, you're probably going to do it too."
During the visit, she brought her boyfriend — who is also struggling with an opioid addiction — in hopes of introducing him to OAT.
But Wortman says even he recognizes medicine alone isn't enough, and that proper nutrition, counselling and a strong support network are also necessities for people working toward recovery.
"It is relatively easy to get someone onto an opiate agonist therapy," he said.
"But all these other supports that are, I would say even more important or harder to access, housing in particular."