REGINA - The processes in place for delivering opioid addiction treatment services in the province was one of the focuses in the Provincial Auditor’s 2025 Report - Volume One.
Provincial Auditor Tara Clemett made several recommendations in her report released on Tuesday, in which she called for more consistent processes across the province to offer opioid addiction treatment, or OAT for short.
Clemett noted that in 2023, 341 people died from drug toxicity in Saskatchewan, an over 22 per cent increase. Their audit focused on the 12 directly operated inpatient programs operated by SHA, not those run by service providers.
One of her recommendations focused on communications to the public about treatment services.
“Overall, we found the Authority needs to clearly communicate the opioid addiction treatment services available in the province to the public in accessible ways, such as easy-to-navigate websites or posters in shelters and emergency rooms,” Clemett said.
“Lack of clear and direct information about available treatment options can prevent individuals or their families from finding appropriate help and resources when needed.”
Clemett said their audit found the SHA did not analyze the supply and demand for opioid addiction treatment services or wait times at their outpatient clinics to determine whether the services are appropriately located.
“For example, we found Lloydminster and Estevan had higher average drug toxicity deaths, but do not have OAT clinics in their communities. The Authority did not have a reasoning as to why not. This lack of analysis increases the risk of not having treatment services where needed, as well as increases the risk of clients not receiving timely treatment. Our testing found clients waited on average four days in Kamsack and 4.7 days in Saskatoon between initial contact with the OAT program and first appointment with a prescriber. Good practice recommends that clients wait no more than three days. Not providing treatment within three days delays recovery as long waits increase the risk of relapse or not seeking treatment at all.”
Clemett also noted the SHA needs to always complete opioid withdrawal assessments before prescribing OAT medication, such as methadone, to clients.
“Not consistently performing and documenting opioid withdrawal assessments limits healthcare staff's ability to determine a client's level of opioid dependence to help determine the right time to safely start a client on medication.”
Clemett said they also found the SHA did not consistently provide OAT or opioid medications to clients with opioid use disorder during detox.
Finally, she said, she called for the SHA to consider “one central IT system to track and assess its opioid addiction treatment services, as well as establish key performance metrics for its services to assess impact and improve client outcomes.” Metrics should include tracking wait times, rates of clients continuing treatment, and numbers of clients reporting improved quality of life, she said.
“Consistently tracking key information would enable the Authority to sufficiently analyze trends and assess whether its clients' needs are met and it had impact. Effectively delivering timely opioid addiction treatment services can reach those struggling with addiction, reduce the risk of overdose and death and help address this public health crisis.”
SHA response
In a statement, the SHA said they were taking action to respond to the recommendations in the Auditor's report and “has developed implementation plans to align with the Government of Saskatchewan's Action Plan for Mental Health and Addiction Services over the next three years.”
According to the SHA statement, they will respond by:
Aligning opioid addiction treatment resources across the province with community needs, particularly in underserved areas with higher rates of drug toxicity deaths;
Developing and implementing provincial work standards for intake and withdrawal assessment, treatment and referrals, and discharge and transfer to other services to improve outcomes across the continuum of addiction services;
Improving the effectiveness and responsiveness of provincial OAT services through standardized data collection and implementation of key performance indicators to monitor trends, identify gaps, and determine if services are meeting client demand and achieving outcomes;
Establishing maximum wait-time targets for initial appointments and follow-up assessments, optimizing prescriber hours in high-demand facilities, and developing and implementing the VAAM (Virtual Access to Addictions Medicine) program to reduce delays in treatment; and
Ensuring access to OAT services by routinely offering OAT to all clients with OUD in all inpatient detox settings in the province, tracking key outcomes, including re-admission rates and treatment retention, to assess the impact of long-term recovery outcomes.
