Transcript Community Opioid Addiction Program Tara McIntyre, Addiction/Mental Health Counsellor Megan Neill, Coordinator/Trainer of Specialized Programs.

Community Opioid
Addiction Program
Tara McIntyre, Addiction/Mental Health Counsellor
Megan Neill, Coordinator/Trainer of Specialized Programs
Principles of COAP
Program Overview
• Improve health and social outcomes and quality of life for
people living with opioid addictions
• Priority populations include:
• People living with HIV/AIDS and/or Hepatitis C
• Women who are pregnant and/or parenting
• Youth (12+)
• Increase access to opioid addiction treatment and primary
health care
• Improve linkages between community programs
• Reduce involvement with criminal justice system
Community Opioid Addiction Program (COAP)
Direct Client Services
• Screening, assessment, treatment planning, counselling,
and case management
• Ability to meet in the community (e.g. health care centres,
Methadone and Suboxone clinics, hospitals, shelters)
Community Education Services
• Increase knowledge and awareness about opioid addiction
and Opioid Substitution Therapies (OST)
• Presentations, educational events, consultation services
Individual Counselling: Common Themes
• First exposure to opioids often obtained through legal
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prescription from physician
Prescription discontinued due to misuse
Opioid use for pain management purposes
Continued use to manage and/or avoid withdrawal
symptoms
Prescribed OST but supplementing with illegal opioids to
avoid an increase in dosage
Readiness to taper off OST
Not fully aware of all treatment options and potential
impacts and/or side effects of OST
Unique Needs of the Population
• Stigma of OST
• What is abstaining?
• Is OST treatment considered an addiction?
• Chronic Pain
• Narcotics Anonymous
• Side effects and how to manage
• Advocacy with doctors and pharmacists
• Women Specific Services
• Not enough research for women’s issues (e.g. OST effects on
women, estrogen levels)
Two Groups: To Meet the Needs
OST Information Session
• Address the lack of knowledge about Methadone/
Suboxone
• Provide treatment alternatives
• Empower individuals to make informed decisions
OST Support Group
• Evidenced-based practice that OST combined with
counselling is important for a successful recovery
• Group members in various stages of change
• Shared experiences and common themes
OST
Information
Session
Educational group
for people
contemplating
OST and/or on
OST, family
members, and
service providers
OST Information Session
Outline of the group:
• Information about Opioids
• What is Opioid Substitution Therapy?
• Benefits and Drawbacks
• Things to Consider with OST
• Mixing OST with Other Substances
• Overdose
• Resources
OST Info Session: Successes
• Creating a safe space to address questions and concerns
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about OST
Un-biased presentation
Allows individuals to make informed treatment
choice/decision
Building capacity of service providers
Providing well-researched information from the MMT
guidelines and CPSO
Resolve ambivalence
OST Info Session: Challenges
• Lots of information to cover in a short period of time
• Attendance issues – not reaching the populations who
would benefit from this material
• Taking it “on the road”!
OST Info Session: Feedback
• From clients:
• Information presented has been useful in helping them make a
decision to start OST
• Information has helped them feel confident in their decision to
choose OST as a treatment option
• From family members:
• More likely to suggest OST to someone
• Consider OST if unable to go “cold turkey” from opioids
• From service providers:
• Information presented will help them better support their clients on
OST
• Feel better informed about OST and where clients can access
these treatments
OST
Support
Group
10 week psychoeducational &
support group for
people on OST
OST Support Group
Topics
OST and Me
2. Strength Through Stigma
3. Personalizing Your Treatment
4. Lifestyle and OST
5. OST Side Effects
6. Pain Management and Types of Pain
7. Safe Coping Skills
8. Working with Worries
9. Healthy Relationships
10. Beyond OST: Progressing Through Recovery
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OST Support Group: Benefits
• Unique:
• No other similar groups
• Specialized focus results in high affinity
• Safe, non-judgemental, supportive environment
• Variety of participants on methadone and Suboxone and
in various stages of change
• Share what works and what does not work about OST
• Helps reduce stigma of OST
• Group facilitators at the Suboxone clinic – wrap around
and client engagement
OST Support Group: Challenges
Challenges:
• Group dynamics
• Stigma conversations and over-generalizations
• Remind participants it is not a race to get off OST – can
stall progression in treatment
Areas to Improve:
• Increased referrals to OST information session
• Offer more women-specific information, especially around
side effects
• More visual aids (e.g. videos)
• Promoting/informing patients at the clinics
COAP Clinic Collaborations
• Through service delivery partnership, increase capacity
for :
• client engagement and retention for both ADSTV and OST clinics
• ease of access to OST
• meeting individual client needs
• consultation between ADSTV and OST/health care providers in our
community
• being responsive to the relapsing nature of opioid/substance use
COAP Clinic Collaborations
Thomas Street Treatment Clinic, Strathroy, ON
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Located in rural SW Ontario
Serves Strathroy and surrounding area
Serves 60 patients
Must be a clinic patient to access counselling onsite
Two physicians, Two administrative staff
Dr. Lee Suboxone Clinic, London, ON
• Located at CMHA and operates out of same location as medical clinic
• Serves London population
• Serves 24 patients and increasing
• Must be a clinic patient to access counsellors onsite
• One physician, one admin staff
COAP Clinic Collaborations: Service Profile
Thomas Street Treatment Clinic, Strathroy, ON
• One counsellor, onsite twice a week
• Clients required to meet with COAP counsellor at least once
• Full individual community treatment services onsite
• COAP Staff does not perform clinic duties
Dr. Lee Suboxone Clinic, London, ON
• 2 counsellors, onsite once a week
• Clients required to meet with COAP counsellor at least once
• Limited individual community treatment onsite, depending on
availability
• COAP staff perform clinic duties: intake, screening and urine drug
screening (UDS)
Questions/Comments/Discussion