The Alberta model refers to the recent largescale $140 million investment of Alberta’s government to fulfill their campaign promise of creating four thousand new treatment spots in response to the overdose crisis.
Dr. Rob Tanguay is one of the leading consultants on Alberta’s addictions and mental health strategy. He is Alberta Health Services (AHS) Provincial Medical Lead on opioid dependency training and also AHS clinical lead for their Opioid Dependency Treatment Program. He also sits on the Canadian Society of Addiction Medicine’s (CSAM) board of directors as Alberta and Northwest Territories regional director.
For years there’s been concerns that opioid manufacturers had too much say over training and educating Canadian physicians on how they treat and diagnose physical pain. It looks as though that legacy continues within the addictions field as governments invest in treatments during an overdose crisis.
Tanguay takes money from cannabis producers while prescribing it to patients with pain (as the Medical Lead for Caleo Health’s Pain/Cannabis Program), and while teaching at the University of Calgary medical school what role cannabis might play in addressing opioid addiction. Caleo is owned by Natural Health Services, whose investor prospectus states on page 21 that “NHS physicians can see from 8-10 patients per hour. At an average bill rate of $110 per patent to the Provincial Health Insurers and a 70-30 split on fees to the benefit of the physicians’ results in NHS’ doctors being some of the highest paid in the industry.”
In his role as the medical lead for AHS opioid dependency training Tanguay is responsible for developing the province’s addictions course, a provincial requirement to receive prescribing privileges from the Alberta College of Physicians and Surgeons.
While overseeing the creation of AHS addiction medicine curriculum, which recommends suboxone as a first line treatment for opioid dependence, Tanguay was also taking money from the drug’s manufacturer, Indivior. Tanguay owns a conference organizing company (RLT Conferences) that takes money from several pharma companies including Indivior, which was recently charged with fraudulent marketing practices by the United States Justice Department. According to the indictment Indivia ”obtained billions of dollars in revenue from Suboxone Film prescriptions by deceiving health care providers and health care benefit programs into believing that Suboxone Film was safer”.
Dr. Tanguay takes money from Purdue while teaching doctors when and how to “deprescribe” drugs like OxyNeo, which Purdue makes. Tanguay took educational speaker honoraria from suboxone producer Indivior, Canopy, Pfizer, Otsuka and also sat on Lundbeck and Indivior Advisory Boards.
Alberta's government is moving forward on his recommendations. In December 2019, Alberta invested $8 million in “wrap-around supports” for patients receiving opioid-agonist therapy (OAT), although associate health minister Jason Luan that there were “funding details still to be worked out” at the December press conference.
According to his more recent 2019 CSAM disclosure, in which Tanguay indicates he “Secured unrestricted conference grants for my company RLT” to organize conferences including one called Marijuana Day, sponsored by Canopy and another called Trending in Psychiatry, sponsored by Otsuka, Pfizer, Purdue, Lundbeck, and others.
In 2018, Tanguay published an article in the Canadian Journal of Addiction (CJA) on cannabinoids as a treatment for psychosis in which he declared no conflicts of interest despite taking money from cannabis producer Canopy. CJA published a erratum after later discovering this, and publicly cited Tanguay’s many conflicts including Canopy and Indivior.
It must be considered that Tanguay and AHS were following the lead of national guidelines that recommend suboxone as a new first-line treatment. However one might also consider Indivior’s influence over previous guideline recommendations cited by AHS in their decision.
Tanguay sits on an SCS review panel that is putting a health service on public trial, and profits directly from the overdose crisis.
Note: previous version of article stated CJA issued a retraction, but it was an erratum.