Recovery-Oriented Corrections

Christine Bootsma – Recovery Approaches/Special Populations DAY 1 April 12th, 2022 Neilson Room 1

Addiction Conference

Session Description

Focusing on Recovery-Oriented Corrections. Looking at a strengths-based approach to involvement with the criminal justice system. How correctional centres can build bridges into the community based on strengths and partnerships. Lastly, looking at the effects on those who participate in the therapeutic community (outcomes) compared to others.

Learning Objectives

  • Demonstrate how correctional centres can build bridges into the community.
  • Measure the outcomes of those in a TC vs those not

BIO

Christine attended Royal Roads University where she got her degree is Justice Studies. Christine has been with BC Corrections since 2007, during that time she was part of the Guthrie Therapeutic Community, the only therapeutic community within a correctional centre in Canada. Christine was also part of the development in Right Living within Corrections and developed training for all correctional staff. In 2018, Christine won the Premier’s award for Emerging Leader with the work she did in developing programs for men at Nanaimo Correctional Centre.

The Heroism of Recovery

Michael Shellenberger

Investigator Michael Shellenberger April 12th 3 pm

Addiction Conference
Michael Shellenberger

The Heroism of Recovery

Since 2000, harm reduction advocates have argued that their approach saves lives. But during that time, drug deaths rose from 17,000 to 100,000 deaths, in the U.S. alone. Harm reduction no doubt plays an important role through needle exchange and opioid replacement therapy. But the goal of addiction treatment should be recovery, as it is Portugal, the Netherlands, and other pioneers in drug treatment. In this talk, Michael Shellenberger, the best-selling author of San Fransicko will describe why he views those who have recovered from addiction as heroes who offer great insights into the human condition that are of value to all of us, whether or not we have suffered from addiction. Shellenberger will make the case for why we need an international “Voices and Stories of Recovery” public education campaign to counter the drug addiction and drug death epidemic that is sweeping the globe.

Learning Objectives

  1. Learn the contributions and limits of harm reduction
  2. Learn why addiction recovery offers individual and societal benefits harm reduction cannot offer.
  3. Learn how an international pro-recovery campaign could save millions of lives.

BIO

Michael Shellenberger is a Time Magazine “Hero of the Environment,” Green Book Award winner, and the founder and president of Environmental Progress.

He is the best-selling author of the critically-acclaimed books San Fransicko: Why Progressives Ruin Cities (HarperCollins 2021) and Apocalypse Never (HarperCollins 2020).

He advises policymakers around the world including in the U.S., Japan, Taiwan, South Korea, the Philippines, Australia, United Kingdom, the Netherlands, and Belgium

Addiction, Recovery & the Safety Sensitive Workplace: Current Reality & a Path Forward

Dr. Paul Sobey; Dr. Carson McPherson, Eileen Maloneywhite and Darren Erickson

April 13th 2022 Stephen Room, this is a 2-hour two part session.

Part 1 – 11:30 am – 12:30 pm

Part 2 – 1:30 pm to 2 :30 pm

Session Description

Those working in the construction sector are disproportionately impacted by substance use and related challenges1,2.  Construction workers are also at higher risk for disability compared to the general workforce2.  A report from British Columbia’s Fraser Health Authority showed that the building trades sector was found to be the most common industry whereby men were admitted to hospital following serious non-fatal overdoses in private residences1.  The risk and costs associated with undiagnosed, untreated, or under-treated substance use and related challenges within the construction sector are immense. These detrimental impacts range from lost productivity (lost value of work due to premature death, long and short-term disability (absenteeism, injuries and impaired job performance due to substance use and impairment)4 to increased healthcare costs and in some cases fatalities3.  Just as the workplace can exacerbate substance use and related challenges, such environments can and should be conducive to initiating and maintaining recovery.  This presentation will provide a comprehensive review of the challenges facing the construction and other safety/decision sensitive sectors as well as strategies and best practice models to initiate and maintain recovery-oriented initiatives in the workplace.

Learning Objective

  • A comprehensive understanding of the of current challenges and opportunities for progress facing the construction and similar safety sensitive workplaces;
  • General overview of the state of workplace policies and management of substance use challenges within the construction sector;
  • Learn to identify substance use and related problems in the workplace, often considered ‘invisible disabilities’;
  • Approaches to responding to substance use and related challenges in the workplace as well as effective return to work and recovery management initiatives;
  • Learn about current evidence-based treatment approaches, harm reduction strategies and how they relate to occupational addiction medicine.

References

  1. Alberta Health Services – Addiction and Mental Health (2010). Workplace addiction and mental health in the construction industry: Literature synthesis. Edmonton, Alberta, Canada: Author.
  2. Canadian Mental Health Association. (2019). Impairment in the Workplace –What your organization needs to know. Retrieved from https://ontario.cmha.ca/wp-content/uploads/2019/05/CMHAOntarioImpairmentPolicy2019.pdf
  3. CSUCH. Canadian Substance Use Costs and Harms. Retrieved from https://csuch.ca.
  4. Fraser Health. The Hidden Epidemic: The Opioid Overdose Emergency in Fraser Health. January 2018.

Bio’s

Dr. Paul Sobey

Dr. Sobey completed his medical training at the University of Alberta in 1986, and a fellowship in Addictions at University of Cleveland Hospitals and Case Western Reserve University in 1989. He received Board Certification from the American Board of Addiction Medicine in 2010 and became a certificate of the Canadian Society of Addiction Medicine in 2012, and is a Clinical Instructor at the University of British Columbia Faculty of Medicine, Department of Family Practice.

Dr. Sobey was formerly the Regional Divisional Lead for Addictions in Fraser Health Authority from April 2011 to May 2013. He was on the Member Advisory Committee on Opiate Dependence – College of Physicians and Surgeons of British Columbia (CPSBC) from 2002 to 2013 and was Chair of the committee from 2011 until 2013. He is also the former chair of CPSBC Methadone Maintenance Committee.

Dr. Sobey is a full-time addiction medicine physician and is currently the lead physician and an addiction medicine consultant for the Royal Columbian Hospital Addiction Medicine Service in New Westminster, BC. He also acts as an Occupational Addiction Medicine consultant to both public and private organizations. He has an active methadone practice in New Westminster and also works in abstinence-based care.

Dr. Carson McPherson

Carson holds a Doctor of Social Science, Master of Science, and Master of Business Administration degrees.

Carson brings a wealth of knowledge and experience to the organization, as well as a passion for recovery-oriented treatment. As a leader in both addiction care and research, Carson has presented at numerous national conferences and has published a variety of peer-reviewed research in the area of substance use, chronic pain, health systems, knowledge mobilization and family system impacts of addiction.

Carson is also the Senior Advisor for Recovery Research at the British Columbia Centre on Substance Use, sits on the National Policy Committee for the Canadian Society of Addiction Medicine and is a member of the Board for the BC Recovery Council. In addition, he is an adjunct faculty member at Vancouver Island University.

Eileen Maloney-White, BSc. RN. LNC-CSp. COHN COHN(C) CCWS CCAC CPHSA FACLNC

Ms. White is an accomplished Credentialed Occupational Health Nurse; she is the Vice President of the Canadian Occupational Health Nurses Association and is a former director on the American Board of Occupational Health Nurses; she is a member of the American Association of Occupational Health Nurses, American College of Occupational and Environmental Medicine, Aerospace Medical Association, and the Canadian Society of Addiction Medicine. She is the secretary for the Canadian Chapter of the International Nurses Society on Addictions. She serves as an advisor on the advisory committee on the Substance Use & Addictions Program (SUAP) with Health Canada. She is a mentor in Occupational Health Nursing for the Canadian Nurses Association and is a contributor to the Nurse Wellness Network which addresses the struggles of nurses who use substances.

Ms. White is a lecturer and presenter on maintaining safe and healthy workplaces, addiction in the workplace and corporate wellness.

She is a certified addictions counsellor & recovery coach, certified psychological health & safety advisor. She is a legal nurse consultant certified specialist and is a Fellow with the American College of Legal Nurse Consultants.

Darren Erickson

Although I have trained as an engineer and held various technical and leadership roles in my 20 years working in refineries in western Canada and the US, my ‘real’ education comes from listening to colleagues, friends and family who work in the trades; from hands-on-tools to CEOs.  Currently, while working with my team of supply chain professionals in the Regional Municipality of Wood Buffalo, we are listening to understand and help solve the challenges that our industry and many trade workers are experiencing.  As a result of their struggles, many highly skilled trades people are leaving the industry.  As such, it is critical that our industries, contractor companies, labour organizations and support services work together to attract, support and retain the skilled trades required for our essential services.  It is through collaboration and working towards a common goal of viability of Canada’s energy industry that together we can address the looming threat of labor shortages.

The New Science on Addiction Recovery

Dr. John Kelly

April 13 2022 Hyatt Regency Main Ballroom 10:00 AM

During the past 50 years a great deal has been learned about how to provide acute care services for those suffering from addiction, but there has been relatively little emphasis on how best to help individuals attain and maintain remission and recovery over the long-term. Greater recognition of the persistence of post-acute withdrawal phenomena and increased sensitivity to biobehavioral stress had indicated a need for ongoing social and other support infrastructures to enhance coping and resilience and reduce relapse risk. This talk will review the scientific rationale for the need for ongoing recovery monitoring and management services and the recent evidence investigating novel recovery support services.

Learning Objectives,

By the end of this presentation participants will be able to:

1. describe two major biobehavioral deficits facing individuals beginning in early remission;

2. outline the milestones in the process of recovery;

3. specify 3 evidence-based recovery support services

References

1. Kelly JF, Humphreys K, Ferri M. Alcoholics Anonymous and other 12-step programs for alcohol use disorder. Cochrane Database of Systematic Reviews 2020, Issue 3. Art. No.: CD012880. https://doi.org/10.1002/14651858.CD012880.pub2

2. Kelly JF, Bergman BG, Hoeppner B, Vilsaint C, White WL. Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy. Drug Alcohol Depend 2017; 181:162-169.

3. Kelly JF, Greene MC, Bergman BG. Beyond abstinence: Changes in indices of quality of life with time in recovery in a nationally-representative sample of US adults. Alcohol Clin Exp Res 2018; 42(4):770-780.

4. Kelly JF, Fallah-Sohy N, Vilsaint C, Hoffman L, Stout R, Jason L, Cristello J, Hoeppner B. New kid on the block: An investigation of the physical, operational, personnel, and service characteristics of recovery community centers in the United States. J Subst Abuse Treat 2020; 111:1-10.

5. Kelly JF, White WL, editors. Addiction recovery management: Theory, research, and practice. New York: Springer (Humana) Press; 2011.

Bio

Dr. Kelly is the Elizabeth R. Spallin Professor of Psychiatry in Addiction Medicine at Harvard Medical School-the first endowed professor in addiction medicine at Harvard. He is also the Founder and Director of the Recovery Research Institute at the Massachusetts General Hospital (MGH), the Associate Director of the Center for Addiction Medicine (CAM) at MGH, and the Program Director of the Addiction Recovery Management Service (ARMS). Dr. Kelly is a former President of the American Psychological Association’s (APA) Society of Addiction Psychology and is also a Fellow of the APA and a diplomate of the American Board of Professional Psychology. He has served as a consultant to U.S. federal agencies and non-federal institutions and foreign governments. His clinical and research work has focused on addiction treatment and the recovery process, mechanisms of behavior change, and reducing stigma and discrimination among individuals suffering from addiction.

Continuing Education Credits CEUs

We have applied for CEU Credits from the following certification bodies :

CACCF – Canadian Addiction Counsellor Certification Federation      

CCPA  – Canadian Counselling and Psychotherapy Association       

NAADAC  –  The National Association for Addiction Professionals          

VRAC – Vocational Rehabilitation Association of Canada     

BCACC – British Columbia Association of Clinical Counsellors

Applying Contingency Management in Criminal Justice: Swift, certain, and fair responses to substance use.

Dr. Keith Humphreys

Bush and Obama Administration Senior Policy Advisor at the White House Office of National Drug Control Policy

April 13th 2022 1:30 pm Walker Banner Room

Session Description

Continency management approaches are commonly applied in addiction treatment, providing small, immediate rewards for desired behavior changes.  This same approach is increasingly being used in the criminal justice system, which oversees a population of people with prevalent substance use disorders.  This presentation will highlight evidence-based approaches to applying swift, certain, and fair sanctions for substance use to people on parole or probation, presenting evidence that such programs dramatically reduce substance use, crime, and incarceration, as well having radiating public health and safety benefits.

Bio

Keith Humphreys is a Professor of Psychiatry at Stanford University and is an affiliated faculty member at Stanford Law School and the Stanford Neurosciences Institute. He served as a drug policy advisor in the Bush and Obama White Houses, and currently advises many state and national governments on how scientific evidence can inform policies regarding addiction and other psychiatric disorders. His Wonkblogging focuses mainly on addiction, drug policy, mental health and the criminal justice system.

Developing Recovery Communities

David Pavlus April 12th Main Room

Founder Last Door Recovery Society

David Pavlus is the founder of the Last Door Recovery Society, a New Westminster non-profit organization that has been providing long term residential addiction treatment and adjunct family services for over 35 years.

David is a man who embodies both vision and the will to execute that which he believes in. His approach to all thing is life is equal measures of practicality and common sense. While others are still considering ideas David is well on his way to making his ideas a reality. While it can and has been said that David’s leadership style is unorthodox, the success of Last Door and its clients under his leadership is undeniable.

David has innate charisma tempered with humility and strong will; he is able to readily inspire others to his vision and excite them to action. He is man who is able to stay true to a course of action despite the incessant winds of change. Last Door itself is a reflection of his unusual leadership style. It is program filled with folks who produce excellent results while operating from the heart.

Some of the innovations David has brought forth in his 30 year career are nothing short of phenomenal and have yet to be successfully duplicated. An example is pioneering nicotine abstinence in all Last Door programs in 1998. David’s vision required an entire group of 25 clients and 10 staff the stop smoking and stay stopped, all at the same time. No patches or nicotine substitutes, just a vision and a leader.

In 1997 David opened the Last Door Youth Program for boys ages 14 to 18. Although many have claimed to be the “first and only” youth programs of their kind, Last Door Youth program actually is the first of its kind. David’s belief that youth can be addicted and deserve the support of a community of recovery has set innumerable young men on the path to successful and productive citizenship.

David believes families need to heal. Over the years Last Door’s family service shave grown. There are formal groups and weekend retreats but essentially, family is part of the recovery process from the start. Family members both give and gain support during their loved one’s recovery. Family Day held each year, is a testament to the family work done at Last Door.

David had a vision founded on his own experience that it takes a community to heal addiction. Thirty years later we witness the vibrant and amazing New West Recovery Community. This community is filled with people who believe in and support recovery and owes its underpinnings to David’s ideas and believes and his willingness to put his money where his mouth is. PRIDE floats, Family Days, Sports Days, sun run…these are all integral parts of the community founded on David’s adage that recovery should be and can be fun!

David is a man of action. He believes that people need purpose and dignity. As a result he had a vision for Last Door to offer a rural program to its community members. In 2014 Last door purchased a 40 acre site in mission BC that is now known as Keystone. This is a place of beauty and peace where hands are busy and hearts and spirits are fulfilled.

David believes in the people who work for him. He has trained hundreds of recovering people to work at Last Door and throughout the addiction field. There are Executive directors, Program Directors, outpatient counselors, detox workers and therapists who got their career start under his tutelage. David teaches his staff to strive for excellence and lifelong learning but to also enjoy their work lives and be fully committed to task at hand.

In the larger recovery community David is a sought after speaker. His voice of recovery is strong, clear and unassuming. He moves relentlessly in the direction of the solution and away from the problem. We can all learn a lot from David.

In 2019 at Last Door’s Annual General Meeting, David made the announcement that Jared Nilsson as the new Executive Director.

David Pavlus ICADC CCS

Building Bridges, not Road Blocks, Alberta’s Virtual Opioid Dependency Program.

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).

Evidence Based Medications in a Recovery Oriented Systems of Care

Dr. Launette Rieb, Dr. Rob Tanguay, Dr. Meldon Kahan

April 13th 2022 11:30 am Neilson Room 1

Session Description

Medications for Opioid Use Disorder are the Gold Standard and First-Line for treatment initiation. National guidelines do not support detoxification “without immediate transition to long term addiction treatment”. The panel will review buprenorphine-naloxone, the preferred option, followed by methadone and other alternatives, as well as review the possible harms from current practices in Canada such as the practice of safe supply. The practice of Addiction Medicine will be discussed along with common misconceptions about OAT including initiation, maintenance, and tapering.

Learning Objectives:

1.     Participants will be able to apply evidence-based treatments to Opioid Use Disorder. 

2.     After critically reviewing the literature participants will reflect and evaluate on their current practice.

3.     Participants will be able to implement protocols based on current evidence and best practice.

Bio

Launette Marie Rieb, MD, MSc, CCFP(AM), FCFP, DABAM, CCSAM, FASAM

Dr. Rieb is a Family Physician, Addiction Medicine Specialist, and Clinical Associate Professor at the University of British Columbia (UBC). She was the co-creator and initial Physician Director of what is now called the BCCSU Addiction Medicine Fellowship, and contributed to the formation of BC’s first Pain Medicine Fellowship. She works and does research in the areas of pain and addiction, serving clinical populations through ActumHealth, The Orchard Recovery Centre, and St. Paul’s Hospital. Dr. Rieb is the recipient of a UBC Post Graduate Teaching Award and the BC College of Family Physicians Exceptional Teacher Honour.

Dr. Meldon Kahan

Dr Kahan has worked in the addiction field for many years.  He is currently Medical Director of the METAPHI program in Ontario.  METAPHI (Mentoring, Education, and Tools for Addiction: Partners in Health Integration) provides oversight and education for the province’s sixty-five RAAM (Rapid Access to Addiction Medicine) clinics.  Dr Kahan is also the Medical Director of the Substance Use Service at Women’s College Hospital.

Dr Kahan has written a number of peer reviewed articles on addiction, and has been a principal or co-principal investigator on various research studies, including several randomized trials and observational studies.  He has been extensively involved in policy and advocacy. He has helped write several guidelines on opioid agonist treatment and opioid prescribing for chronic pain, and has co-authored several handbooks and guidance documents on addiction medicine.  He has given numerous presentations for local, provincial and national conferences.  His main interest is the integration of addiction medicine into primary care, EDs and hospitals.

Dr. Robert L. Tanguay

  • BSc (Hons), MD, FRCPC, CISAM, CCSAM 
  • Chief Medical Officer, The Newly Institute
  • Clinical Assistant Professor, University of Calgary 
  • Departments of Psychiatry and Surgery
  • President, Pain Society of Alberta
  • Alberta and NWT Regional Director, CSAM
  • Co-Lead, Alberta Pain Strategy, AHS
  • Founder and Clinic Lead, Opioid Deprescribing Program, AHS
  • Co-Founder and Co-Lead, Community RAAM, AHS
  • Hotchkiss Brain Institute & Mathison Centre for Mental Health

Dr. Tanguay is a Psychiatrist who completed two fellowships, one in Addiction Medicine and one in Pain Medicine. He is a clinical assistant professor with the departments of Psychiatry and Surgery at the Cumming School of Medicine, University of Calgary.

Most recently Dr. Tanguay helped found and is the Chief Medical Officer and Vice President of The Newly Institute, a program dedicated to providing medical and psychological intervention for people living with complex and treatment-resistant mental health disorders such as PTSD, depression, anxiety, addiction, and chronic pain including access to psychedelic-assisted psychotherapy. He is the former Medical Lead for the Alberta Addiction Education Sessions for Alberta Health Services (AHS). He is the Regional Director for Alberta and North West Territories for the Canadian Society of Addiction Medicine (CSAM) where he sits as a board member, the President of the Pain Society of Alberta, and the co-chair of the internationally recognized Alberta Pain Strategy.  He is the founder of the Opioid Deprescribing Program with AHS, the Rapid Access Addiction Medicine (RAAM) Community Clinic with AHS, and the Transitional Outpatient Pain Program for Spine (TOPPS) clinic working with spinal surgeons to optimize spinal surgery outcomes.

Academically, he is involved in research in trauma, addiction, chronic pain, opioids, cannabis, and psychedelics and is a member of the Hotchkiss Brain Institute and the Mathison Centre for Mental Health Research & Education at the University of Calgary.