Moncton woman able to resume opioid addiction treatment after birth control dispute with doctor

Until she had a confirmed appointment for the next dose of her opioid-addiction treatment, Rebecca Billard felt on edge.

But after she got her second injection of Sublocade last week, she felt a wave of relief.

"It eliminated so much stress and panic," Billard said. "It makes me happy, and hopeful for the future."

Earlier this month, Billard, 32, spoke out about losing access to her opioid-addiction treatment after she and her doctor disagreed on her chosen method of birth control.

Sublocade, a medication delivered via a monthly injection rather than a daily dose, helps with the powerful withdrawal symptoms users often feel when they stop taking opioids.

According to the product monograph, Sublocade, which was approved by Health Canada in 2018, may pose a risk to an unborn baby should a woman become pregnant while taking it.

"Given the high degree of uncertainty in terms of safety to both the mother and unborn child, Sublocade use should be avoided in women of childbearing potential who are not using an effective and reliable method of contraception or are judged not able to comply with contraceptive methods," the product monograph says.

Billard's doctor told her that she wouldn't be able to continue with the treatment unless she switched to what Billard felt were "invasive" forms of birth control. The doctor suggested long-acting, reversible contraceptive methods, such as an intrauterine device (IUD) or a hormonal implant, would be required for her to continue treatment.

Billard takes the patch form of birth control and had to provide proof of a negative pregnancy test before getting her first injection. Horizon Health Network, which runs the previous clinic Billard attended, did not respond to a request for comment this week.

A spokesperson with Indivior Inc., the manufacturer of Sublocade, said its product monograph doesn't "recommend or stipulate a specific method or recommendation for contraception."

After hearing Billard's story, Dr. Christopher Levesque got in touch with Ensemble Moncton, a harm reduction organization Billard has been consulting, to offer his help.

"I reached out and said, 'Look, I'll sit down and talk with you and we'll discuss it and we'll come to a decision between the two of us,'" said Levesque, who works at the Cameron Street Clinic in Moncton.

When treating patients with Sublocade, Levesque said he makes sure to explain the concerns and potential risks to them.

"The patient should understand what the risks are associated with any form of treatment and then with that understanding, make an informed consent as to whether they wish to continue with the treatment or not continue with the treatment," Levesque said.