Committee to Evaluate Drugs
c/o Brent Fraser,
Director Drug Programs Branch
Ministry of Health and Long Term Care
3^rd Floor, 5700 Yonge St.
Toronto, ON M2M 4K5

There is strong evidence that addictive disorders are chronic and relapsing conditions that respond well to pharmacotherapies. Most patients with addictive disorders are seen within primary care settings by their family doctors who have to often refer them to specialized services. Due to the several hurdles faced by these patients, they do not get access to effective treatment. Recent advances in the neurobiology of addictions and the approval of several medications increases the treatment options available to Ontarians.

Notably, there are three approved medications for treatment of tobacco addiction (nicotine replacement therapy, bupropion and varenicline); three approved medications for alcohol dependence treatment (acamprosate, naltrexone, disulfiram); and three approved medications for long term opioid treatment (buprenorphine, methadone, naltrexone). Medications are available to perform detoxifications from opioids, alcohol and benzodiazepines. While these medications are safe and effective, they are under prescribed.

The goal of the CAMH Development and Dissemination Project is to remove barriers to the access of medications for alcohol, tobacco and opioid dependence by patients. The undersigned request that the evidence-based medications for alcohol, tobacco and opioid dependence be listed under Ontario Drug Benefit Formulary. The decision to use these medications should be based on clinical considerations, co-morbid psychiatric and medical conditions and psychosocial factors best evaluated by the treating physician.

Yours truly,

Peter Selby MBBS, CCFP, FCFP, MHSc, Dip ABAM
Clinical Director, Addictions Program
Head, Nicotine Dependence Clinic
Centre for Addiction and Mental Health
Associate Professor, Departments of Dalla Lana School of Public Health,
Family and Community Medicine, and Psychiatry
University of Toronto

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