Medications available in Canada

[karenzkarz]

Hi all,

I am just wondering what medications are currently available in Canada? My husband is an alcoholic and is going to see the doc on Monday and I see many medications being discussed but I am unsure of which ones are available in Canada. If anyone has any info on what is available in Canada, I would greatly appreciate it. He went to see a doc a few days ago who told him there is nothing available and that there is nothing wrong with having a few. He was a quack so he is going to see another doctor but now I am nervous that this one may be unsure/unknowledgable/etc on how to treat addiction.

[baclofan]

Medications available in Canada

Hi Karen, below is the link to CAMH site that provides a list of meds for AL addiction available in Canada, actually it's a part of a toolkit offered for primary care physicians throughout Canada.

Click on the link below, next scroll down and click on: Medications for alcohol dependence

Dealing with Alcohol Problems

Unfortunately most of family docs are not familiar with some of those meds as an off-label treatment for alcohol dependence...well they are all familiar with antabuse/ disulfiram but they don't want to prescribe it anymore plus many of them are misled that antabuse is no longer available in Canada.

[karenzkarz]

Medications available in Canada

Thank you for getting back to me so quickly. I really appreciate it. My husband and I did go see a GP this week who said that Antabuse is no longer available. I called Costco where I usually get my prescriptions and they had never heard of it. I called another pharmacy that I know of where I see Methadone administered and they told me Antabuse is no longer available in Canada. I have called the addiction recovery centre for a recommendation to a dr who is familiar with addiction problems and they couldn't even recommend a doctor. I am very hopeful that the doc we will see next week will be helpful but I am very unsure after the experience we have had. At least if I am able to go prepared with information such as this, it may be better. Scary situation when you are trying to get help and outside of checking yourself in for 6 days detox there isn't much else available.

[baclofan]

Medications available in Canada

As I said before most GP's are misled that antabuse/ disulfiram is no longer available in Canada, it's still out there...I know that for a fact plus that CAMH link I provided in the previous post still lists antabuse as a med of choice. The problem is that is hard to find a pharmacy that would know how to fill your prescription. When I was offered antabuse the addiction Dr at the rehab knew onlyone pharmacy throughout Toronto.

Good luck with the appointment!

Btw, beeing unable to find a Dr specializing in addiction I would try (currently am) a Psychiatrist because most of them have more knowledge than GP in regards to addiction and they are more flexible prescribing meds for 'off label' use.

[Running4life]

Medications available in Canada

Hi:
Antibuse is available in Canada. I believe some pharmacies make their own. I am currently taking it. I would look for an addiction specialist or services that deal with addiction. They may know where to find it. Campral is also available in Canada.
Good luck.

[MusiciansMallet]

Medications available in Canada

Well, to put my $0.02 in, its hard to say for several reasons: 1) I'm in the US, where health care is a business & isn't single-payer, patient oriented, nor focused on *prevented care*; 2) it is also hard to say b/c I don't know the background of your husband's alcohol dependency & health history--this out is best achieved via face-to-face "non-systematic interviews" (assuming your doctor is competent, because there is quite a lot of incompetent ones, well at least here in the US who look at keeping people alive and well as a f*cking business)... & do not be afraid to ASK QUESTIONS! And do your research! (good start here!) & a follow up poster did refer (or imply) that you & your husband are seeing a PCP or gen practitioner, so unless I misunderstood the interaction between you two it didn't seem as if this is the case w/ your upcoming appointment? although correct me if i'm wrong!

Anyway, here are a few medications available which are commonly used for alcoholism:


Topiramate (trade/brand name: Topamax) & Acamprosate (trade/brand name: Campral)
Both of these drugs are minor GABA-a agonists and block glutamate (which is what alcohol does). Although their effects are very minor.. They are more or less used after sobriety to reduce excitotoxicity, or brain damage, brought about by excessive levels of neurotransmitters (that is, if your husband is a daily drinker)
...Moderately prescribed, although usually by psychiatrists with addiction specialties...

Benzodiazepines (Xanax, Valium, Restoril, Ativan, etc)
These drugs are most effective for assisting an alcoholic in the weaning process, although they're more addictive in their own right and will definitively cause withdrawal symptoms if used daily/semi-daily for a month (and sometimes less). Because of this, they're only used for roughly 2 weeks maximum. Usually here in the US- these are only prescribed by a family doctor with whom you have a close relationship with, otherwise they're only used within inpatient detox centers. In severe cases (28g of alcohol, at the least, used daily daily, for period around 12 months) sometimes phenobarbital is used in place of benzodiazepines, this drug is a barbiturate and is more potent/effective in treating alcohol withdrawal. This is rare (again, by my experience here in the US) and is usually only prescribed initially in detox clinics (although sometimes follow up prescriptions are provided for maintenance or a slower wean after inpatient detox). Barbiturates are even more addictive and cause even more severe withdrawal than benzodiazepines if the dose is not properly weaned or titrated downwards over a long period of time.
...Moderately prescribed; barbiturates are rarely prescribed for alcoholism...

Baclofen
This drug is a GABA-b agonist; its mechanism of action in treating addiction/alcoholism is really unknown. One would think there is some cross tolerance between GABA-a agonist drugs (like alcohol, barbiturates, or benzodiazepines)... but there isn't; and this is from my own personal experience. It has been a month and I am still at 1/3 the prescribed dose of my baclofen dose due to my dependency on a GABA-a agonist- i just can't take it due to exasperated side effects! But, I will say; even at a mere 30-40mg per day, I have noticed very helpful effects in mediating my dependency; it is not a "replacement" drug like benzodiazepines by any means, but, rather it makes one not really care for--or really want--GABA-a agonist drugs (at least in my experience).
...Not commonly prescribed in the US; more commonly prescribed in Canada & in Europe for alcoholism; although not as common as the following two drugs...

Naltrexone
This drug doesn't even act on the GABA-complex (where alcohol acts)... in fact, its more similar to "Narcan"--which BLOCKS opioid receptors and will bring someone overdosing on opiates out of near-death! Its mechanism of action isn't known, but it's efficacy is definitely known.. it both helps with reducing intake of alcohol & in maintaining a need/want to not relapse.
...Moderately-to-commonly prescribed...

Disulfiram (brand/trade name- Antabuse)
This drug isn't of much use during active alcohol use (especially if your husband still *wants* to drink on some level). Its main function is to cause sickness in individuals who drink after abstinence is achieved. It acts by interacting with similar liver enzymes that metabolize ethyl alcohol, and after a few drinks; you will feel extreme hangover-type effects rather than the typical sought after euphoria/high/etc. The main draw back of course is that the patient can just stop taking his or her medication if he or she plans to drink, as it is not a very long acting drug
...Commonly prescribed...


PRIOR TO YOUR DOCTOR'S APPOINTMENT:
I highly recommend doing a search on commonly utilized drugs in Canada using google or bing; be sure to include your federal substance overview agency (such as the US equivalent to the FDA) in your search.

ALL THE LUCK TO YOU AND YOUR HUSBAND! I hope he finds the help/assistance he needs! You are a great wife for dealing with this... any family member of an addict/alcoholic (same thing) or loved one of an addict/alcoholic who deals with addiction should deserve an applause! Anyway, take care! Post back with your results from your doctor's appointment, will you?

[Ne/Neva Eva]

Medications available in Canada

Hey, Karen. Welcome to the forum, and congratulations on the proactive plan!

There are several reasons that doctors don't really prescribe antabuse anymore. I think a doctor could fill you in on those reasons, but I'll give it a go. It's really hard on the liver, so for many of us, it's not a good option. It doesn't help in the sense that it alleviates any aspects of the disease; craving in particular, but also all of the other things that come along with sudden sobriety (depression, mood swings) and it doesn't do anything other than exacerbate anxiety. Obviously it's not a great choice for a lot of people. Which is not saying it's not an option.
There are several people around here who use it in combination with other medications. It takes the option of drinking completely off the table, and that's particularly good if he opts for a medication he can't take with alcohol.

The others are also not very effective for most people, but when they work, they work! So it's worth the exploration. There are definitely treatment centers in Canada that use all of the meds, and absolutely doctors who can help. It's a big country, I know! :H (I may be American, but Canada's close so I know a little bit about the size of it at least. ) My point is that you might be able to get some information about who to see from a doctor that is not nearby.

I'll try to find the information from a thread here about this. You can google it, which is the best way to search. Include MWO or My way out in the google search. A couple of Canadians were around here for a while and left some good stuff behind!

Hang in there!

[karenzkarz]

Medications available in Canada

Thank you everyone for your quick responses and information. We are planning on seeing another GP on Monday morning. She is taking new patients so I am assuming she is young. I feel better that she is a newer doctor since she hopefully is more aware of how alcohol is treated these days especially after seeing a 60 year old+ doc last week who was clueless. I guess that is probably a universal problem. I am trying my best to be supportive and help him find ways that will work for him along with improving my own quality of life. He wants to do the Antabuse thing due to the fact he simply will not be able to drink and trust issues that have arisen because of a lifetime of drinking while he denied he was drinking all the time. I discussed with him he may need to get something for whatever it is that causes him to drink or crave it. He says he doesn't crave it but I can't imagine how he doesn't. I think it is part of his whole denial and not wanting to admit he isn't in control of his drinking. I don't believe he suffers from any type of withdrawl when he does not drink, however I would think he has never gone more than 7 days without a drink in about 30 years. I am going to ensure that we are armed with as much information as possible when we see the doc on Monday and I will post here to update. Thank you for the support and info.

[MusiciansMallet]

Medications available in Canada

Neva is great for information on her experiences with baclofen, fyi..... I am not sure how GPs or PCPs function in Canada- but here in the US they're pretty much useless for these issues (usually you see an addiction specialist in your or our case & pay an arm & a leg- its not single payer health care like you guys in Canada, unfortunately! Health care is a BUSINESS, where 45,000 people die A YEAR here b/c of this, & more than half of all bankruptcies are from medical issues here in the US!! Anyway, I'll get off my soap box & digress......); Anyway, a GP or PCP will refer you to doctors who're more specified in whatever issue you're looking into and/or they'll refer you to a specialist (as I mentioned- usually psychiatrists and/or addiction specialists).

I HIGHLY suggest (at the absolute least) researching/reading on the meds I mentioned previously (in that very long post) in wikipedia- particularlry focus on the intro, effects, & pharmacology sections. Then if you have time, take a look a RxList (or similar medical websites, like WebMB- although b/c I have a background in pharmacology I prefer RxList personally)- again, if you use these sites for the most commonly used medications for GABAergic drug addiction--such as alcohol dependency--the drugs I mentioned, & in which spacebebe somewhat touched on, are the one's used for alcoholism.

[baclofan]

Medications available in Canada

i Karen,

karenzkarz;1349643 wrote: My husband and I did go see a GP this week who said that Antabuse is no longer available. I called Costco where I usually get my prescriptions and they had never heard of it. I called another pharmacy that I know of where I see Methadone administered and they told me Antabuse is no longer available in Canada.
You were misled, Antabuse under the name Disulfiram is still available in Canada...the problem is finding a pharmacy that would fill the script.

karenzkarz;1350076 wrote: He wants to do the Antabuse thing due to the fact he simply will not be able to drink and trust issues that have arisen because of a lifetime of drinking while he denied he was drinking all the time.

If your husband decides to pursuit the antabuse option and the new GP agrees on that and in case you wouldn't be able to find a local pharmacy to deal with the script...click on the link below, scroll down and click on Anti-Alcohol Drug (left side), scroll down to 'Getting a Prescription':

"If you are a Canadian resident and your doctor cannot find a pharmacy that dispenses Antabuse, it can be ordered trough..."

Addictions and Recovery.org - Relapse Prevention and Coping Skills

Good Luck with the appointment!

[karenzkarz]

Medications available in Canada

Thanks again for the info. I am going to print it off and bring it to the doc appointment tomorrow. The funny thing with treatment here is I called Addiction Recovery Centre here and asked the nurse there if they could recommend a doc who is familiar with dealing with addiction. See said she couldn't recommend anyone but for me to check to see what docs are taking new patients. I was surprised after the prior experience we had had with the other doc. If we can not get a prescription for Antabuse here thank you for the info where I can get the script filled. As much as everyone (including myself until recently) that there is plenty of support in the community for people who are looking for help, it is not there. It seems the medical and social welfare community has not advanced half as far as they like to think they have. Thank you for all your support. I will update tomorrow when we return from what I hope will be a very positive experience.