Dr. Nathaniel Day
April 12 th 2022 11:30 am Bannerman Walker Room
Session Description
Alberta is an innovation leader in improving access to opioid dependency treatment. Alberta’s Virtual Opioid Dependency Program (VODP) is a publicly administered Alberta Health Services program and has been designed to reduce barriers to care.
Today anyone in Alberta who is using street opioids like fentanyl can receive same day treatment. Anyone in Alberta receiving care in corrections, halfway houses, detox, rehab centers, hospitals or emergency departments can be referred to VODP for ongoing or transitional care.
For too long, access to safe and effective treatment has been limited by the person’s proximity to rare bricks and mortar addictions clinics. Thanks to technology, the barrier of geography no longer needs to stop people from accessing recovery. Alberta’s VODP has provided treatment in over 250 different communities. Currently VODP is helping an average of 290 new clients per month.
Alberta’s VODP utilizes new tools to help people achieve the results they want. Long-acting medication options increase the ability to complete treatment when appropriate. We ensure that every client in VODP has access to a multidisciplinary team with Addictions Counselors, Social Workers, Therapists and Psychiatric Nursing support. We want our clients’ lives to revolve around life and recovery not our program or the pharmacy.
Alberta’s Virtual Opioid Dependency Program is dedicated to collecting and reporting results. This focus on data ensures that innovation and change are always focused on results for our clients. So far, we see improvements in clinical outcomes including reduced drug use, reduced overdoses, reductions in hospital and emergency department utilization, improved social functioning including recovery of social and family roles. We are pleased to report high client satisfaction with the program.
Alberta’s model of rapid access to evidence-based treatment can be replicated.
Learning Objective
Opioid Dependency Treatment should be accessible and focused on client outcomes
Technological innovation, including video, phone and text should be used to increase access to care. Client results from virtually-delivered care in VODP are positive.
Addiction treatment providers can embrace data collection to ensure that services are delivering the needed results.
References
Bruneau, J., Rehm, J., Wild, T.C., Wood, E., Sako, A., Swansburg, J., & Lam, A. (2020). Telemedicine Support for Addiction Services: National Rapid Guidance Document. Montreal, Quebec: Canadian Research Initiative in Substance Misuse; May 15 (47 p.) Version 1.
Eibl, J. K., Gauthier, G., Pellegrini, D., Daiter, J., Varenbut, M., Hogenbirk, J. C., & Marsh, D. C. (2017). The effectiveness of telemedicine-delivered opioid agonist therapy in a supervised clinical setting. Drug and alcohol dependence, 176, 133–138. https://doi.org/10.1016/j.drugalcdep.2017.01.048
Molfenter T. (2015). The pressing shortage of buprenorphine prescribers and the pending role of telemedicine. Addiction science & clinical practice, 10(Suppl 1), A40. https://doi.org/10.1186/1940-0640-10-S1-A40
Mauger, S., Fraser, R., & Gill, K. (2014). Utilizing buprenorphine-naloxone to treat illicit and prescription-opioid dependence. Neuropsychiatric disease & treatment, 10, 587-598. https://dx.doi.org/10.2147/NDT.S39692
Lawrinson, P., Copeland, J., & Indig, D. (2005). Development and validation of a brief instrument for routine outcome monitoring in opioid maintenance pharmacotherapy services: the brief treatment outcome measure (BTOM). Drug and alcohol dependence, 80(1), 125–133. https://doi.org/10.1016/j.drugalcdep.2005.04.001
Weintraub, E., Greenblatt, A. D., Chang, J., Himelhoch, S., & Welsh, C. (2018). Expanding access to buprenorphine treatment in rural areas with the use of telemedicine. The American journal on addictions, 27(8), 612–617. https://doi.org/10.1111/ajad.12805
Bio
Dr. Nathaniel Day received his medical education at the University of Alberta, entering practice in 2007. He subsequently received his American Board of Addiction Medicine Certification in 2010. Dr. Day has spent his career working with clients who live with addiction and mental health challenges. He is the medical director of the Centennial Centre for Mental Health and Brain Injury and is the medical director of Alberta’s Virtual Opioid Dependency Program.
Under Dr. Day’s medical leadership the Virtual Opioid Dependency Program was piloted, implemented and expanded. The program and Dr. Day were awarded the Health Quality Council of Alberta’s (HQCA) Patient Experience Award in 2020. Earlier this year the program received national recognition as a Leading Practice for addiction treatment by the Health Standards Organization (HSO).