Urgent appeal for changes to addiction treatment
FOR IMMEDIATE RELEASE
August 25, 2026
Calgary, Alberta— Reversing an opioid overdose with naloxone is lifesaving, but it does not prevent some life-changing consequences, such as irreversible brain damage. A Letter to the Editor published in the globally renown journal Addiction is calling for change in how clinicians and systems handle opioid overdose risk, particularly with synthetic drugs such as fentanyl.
“Brain injury is a real problem that people aren’t talking enough about,” says Dr. Nathaniel Day, a co-author of the letter and Chief Scientific Officer at the Canadian Centre for Recovery Excellence (CoRE).
“Overdose events can create long-term problems in memory, decision making, and impulse control. Contact sports, including hockey and football, have recognized that even minor brain injuries can accumulate over time and become a serious injury. Each overdose carries risk that real brain damage is occurring, changing a person’s ability to function normally. This makes preventing the next overdose an urgent priority.”
B.C. data shows within one year of a first overdose, adults have a six per cent risk of being diagnosed with a brain injury, while those under 19 years of age face a greater risk at 10 per cent. These statistics do not capture all the people who have had an overdose and did not seek or accept a healthcare assessment.
Research is emerging but the growing physical evidence is already hard to ignore according to Day, who is co-author of the publication. It emphasizes that while naloxone can reverse an overdose, it cannot reverse the brain injury that already occurred due to oxygen deprivation or other toxic effects.
Letter co-author and CoRE CEO, Kym Kaufmann, says “When evidence showed the lasting impact of repeated head injuries in professional sports, we did not simply become better at treating concussions, protocols changed to prevent them. The same principle should guide our response to drug use. We need to move beyond treating overdose reversal as a sufficient endpoint. We need to rethink policies to prevent overdoses from happening in the first place and ensure a system of care is in place to help individuals start on a pathway to recovery.”
The authors also say that current North American opioid treatment guidelines are silent on Acquired Brain Injury and its impact on the treatment of Opioid Use Disorder. Brain injury treatment is not included in addiction guidelines to date. Until these guidelines are updated, the authors recommend clinicians apply currently accepted general brain injury treatment recommendations when caring for patients at elevated opioid overdose risk.
“There are hundreds of thousands of people in B.C. with brain injuries, frequently caused by overdose. Thousands of them also suffer from severe mental illness and addiction,” says Dr. Daniel Vigo, Chief Scientific Advisor for Psychiatry, Toxic Drugs, and Concurrent Disorders, Province of British Columbia.
“During the past decade, more than half the overdose episodes and 40 per cent of the overdose deaths affected people with severe mental illness, for whom most addiction services are woefully inadequate. Our health systems need to be modernized urgently to provide evidence-based, fully integrated mental health and substance use services, with the unwavering goal of preventing addiction whenever possible, and treating it whenever present.”
Brain injury informed medication choices include avoiding medications that cause cognitive impairment. This means avoiding sedating and impairing medications, complex dosing routines, and combinations of medications, unless absolutely needed. Strategies to increase the use of long-acting injectable medications, like buprenorphine, that do not require daily dosing could substantially reduce the risk and severity of an opioid overdose.
Dr. Mauricio Garcia-Barrera, Professor and Associate Dean of Research and Graduate Studies at the University of Victoria says, “Some people living with co-occurring brain injury, mental health and addiction may struggle to follow complex instructions on a form, remember clinical appointments or to pick up their medications at the pharmacy. Access to system navigators, longer duration treatment, and other strategies like simplifying medication doses and limiting medication combinations are appropriate considerations to support recovery.”
This letter was co-authored by Dr. Nathaniel Day, Kym Kaufmann, Dr. Mauricio Garcia-Barrera, Dr. Jitender Sareen, and Dr. Daniel Vigo.
Read the full Letter to the Editor for more information.
About CoRE
Canadian Centre of Recovery Excellence (CoRE) is committed to transforming how recovery is understood and achieved in Canada and around the world. The Centre’s mission is to empower decision making with the best available information to support recovery for those with mental illness or addiction.
Media Contact
Michelle Gurney
Communications Lead
Canadian Centre of Recovery Excellence
Email: communications@recoveryexcellence.org
Phone: 403-431-0759
Recoveryexcellence.org
Share this Post