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
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.
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.
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.
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.
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.
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
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).
Dr. Launette Rieb, Dr. Rob Tanguay, Dr. Meldon Kahan
April 13th 2022 11:30 am Herald Doll Room
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.
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.
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.
Breakout Room – October 6th 1:30 pm Herald Doll Room
Recovery Coaches of Alberta is a new initiative intended to provide certified recovery coaches as a resource for people on their recovery journey. This discussion will discuss how the new initiative will operate in Alberta.
Learn about the new Recovery Coaches of Alberta initiative.
Steve Gaspar is the project lead for Recovery Coaches of Alberta. He has a Master’s degree from the Faculty of Health Sciences at Simon Fraser University. He spent the last decade developing and overseeing several housing first and harm reduction programs in Calgary. He’s also a person in recovery with over 22 years of sustained recovery.
Dr. Charl Els and Dr. Jeremy Beach, College of Physicians and Surgeons of Alberta
April 12th 2022 11:30 am Herald Doll Room
Substance Use Disorders / SUD are expressed within most age, cultural, economic, gender, and occupational cohorts. Physicians are not immune to the disease of addiction regardless of any special knowledge, skills, or experience they may hold by virtue of their profession. When a SUD is expressed within a health care professional, the delivery of safe, effective, competent, compassionate, and ethical care is placed at risk. This session explores the current approaches to treating addiction in the health profession and also addresses alternatives to discipline policies. It outlines the unique challenges these programs face in following a ROSC approach. Creating conditions that encourage early identification, diagnosis, detoxification, reduction of barriers to treatment, and long-term monitoring programs provide the best conditions for mitigating associated risks. Physician health programs offer some of the most favourable outcomes of all addiction treatment programs, and may offer valuable clues to other addiction programs.
At the end of this session, participants will have increased:
Knowledge of the principles of addiction care in physicians.
Skills in applying the prevailing FSPHP guidelines
Appreciation of the unique challenges facing this population
1. Early PH. Physician Health Programs and Addiction Among Physicians. Chapter 49. The ASAM Principles of Addiction Medicine, 6th Edition, 2019, Wolters Kluwer. 2. Physician Health Program Guidelines: Federation of State Physician Health Programs, April 2019. URL: www.fsphp.org 3. Hegmann K, Stewart-Patterson C, Els C, Zipper R. (2018). Independent Medical Examinations and Consultations. American College of Occupational and Environmental Medicine (ACOEM) Guideline, MD Guidelines – Reed Group, 2018. URL: https://www.mdguidelines.com/acoem/foundations/independent-medical-examinations-and-consultations 4. Canadian Medical Association. CMA Code of Ethics and Professionalism. Ottawa: Canadian Medical Association, 2018. Available from: https://policybase.cma.ca/documents/policypdf/PD19-03.pdf 5. Rondinelli, RD, Genovese, E, Katz, RT, et al. Guides to the Evaluation of Permanent Impairment, 6th ed. Chicago: American Medical Association, 2008.
Dr. Charl Els is a fellowship-trained Psychiatrist, Addiction Specialist, and Occupational Physician. He serves as a Clinical Professor in the Department of Psychiatry, the John Dossetor Health Ethics Centre, as well as the Department of Internal Medicine at the University of Alberta, Canada. He serves on the Board of Directors for the Canadian Board of Occupational Medicine. Els is the Editor of a Health Canada funded textbook on Tobacco Control and co-authored several clinical practice guidelines for the American College of Occupational and Environmental Medicine, as well as the Railway Association of Canada. He is the principal author of the national Canadian position statement on cannabis in safety-sensitive workplaces. Els works full-time as a Senior Medical Advisor at the College of Physicians and Surgeons of Alberta. After 20 years in Canada, he remains an avid beginner-level snowboarder.
Dr. Jeremy Beach, MBBS, MD, FRCP(Edin), FFOM, FRCP(C), FCCP, FRCP (Lond)
Assistant Registrar, Physician Health Monitoring Program, College of Physicians and Surgeons of Alberta.
Dr. Beach joined the CPSA in December 2016. He first became interested in physician health in 1992/93 when he authored a report on The Morbidity and Mortality of the Medical Profession for the British Medical Association. He has been on the Advisory Committee of the Alberta Medical Association Physician and Family Support Program for more than 10 years, including prior to joining the CPSA.
Before starting work at the CPSA, he worked at the University of Alberta 2002-2016 in the division of Preventive Medicine Program where he was the Occupational Medicine Residency Program Director for almost 15 years. He retains a position as Emeritus Professor in the Department of Medicine as well as a position as Adjunct Professor in the School of Public Health at the University of Alberta.
The stigma attached to Addiction is a huge barrier when it comes to finding and accepting the supports to recover from this family disease. A larger barrier is found in the South Asian community where being an addict or an alcoholic is looked down upon and sometimes hidden by not only the person affected but also the family. Drinking is a widely accepted part of the functions throughout the year in the community and the behaviour that comes along with it as well. Multi-day open bar wedding celebrations, birthday parties etc. sometimes leading to drug use which is kept a secret and sometimes goes unnoticed or ignored until the lives of the affected and their families start to unravel. What are the supports available and how have these been used by the panellists and how can these be used by the community will be discussed. As well as different approaches to recovery such as 12 step and holistic treatments.
Often, a good therapeutic relationship can be a catalyst for change. I am a Registered Provisional Psychologist and the Counselling Program Lead at Punjabi Community Health Services (PCHS) Calgary. I completed my Masters’ program in psychology from Yorkville University. I have had the opportunity to provide individual, couples, family, and group counselling where we try to meet the individual at the level that they are at. A holistic and client centered approach is what we focus on. I have been working with the organization since 2017 and have had an opportunity to work within various programs including Mental Health, Addictions, and Family Enhancement. It has been interesting to note the group dynamics and the different paths that these individuals come from when providing individual and group counselling to clients experiencing addiction. It is a pleasure working with the South Asian community where everyday is an opportunity to learn. Focusing on the unique strengths that each individual brings to the session is what I always look forward to. It is a pleasure to be part of the Recovery discussion panel.
-To share the Panelists Experience, Strength and Hope in relation to recovering from a seemingly hopeless state of body and mind. -Availability and use of community supports to help achieve lasting sobriety. -Explaining the stigma attached to addiction in ethnic groups and how those barriers are being broken down.
Robby Sidhu, a person in long term Recovery since February 22, 2017 was born and raised in Calgary, Alberta and is the Recovery Advocacy Manager at Fresh Start Recovery Centre as well as an Alumnus. His journey balancing his east Indian heritage while growing up in western society played a huge factor in finding Recovery. The shame attached to addiction in the South Asian culture had him wearing 2 masks in addiction as well as in early recovery. These days he is a big supporter of breaking down the stigma attached to being an addict or alcoholic. Throughout the year he is heavily involved in helping plan different events all in hopes of bringing our Recovery community, Families and Community at large back together . We have heard time and time again the opposite of addiction is connection and that’s a huge piece that has been missing for over the pandemic. He currently serves on different 12 step fellowship committees as well as the Recovery Day and wellness walk committees.
Harman Batth (Sidhu)- Counselling Program Lead Often, a good therapeutic relationship can be a catalyst for change. I am a Registered Provisional Psychologist and the Counselling Program Lead at Punjabi Community Health Services (PCHS) Calgary. I completed my Masters’ program in psychology from Yorkville University. I have had the opportunity to provide individual, couples, family, and group counselling where we try to meet the individual at the level that they are at. A holistic and client centered approach is what we focus on. I have been working with the organization since 2017 and have had an opportunity to work within various programs including Mental Health, Addictions, and Family Enhancement. It has been interesting to note the group dynamics and the different paths that these individuals come from when providing individual and group counselling to clients experiencing addiction. It is a pleasure working with the South Asian community where everyday is an opportunity to learn. Focusing on the unique strengths that each individual brings to the session is what I always look forward to. It is a pleasure to be part of the Recovery discussion panel.
Ganesh Alagh- Was born In Mumbai, India and struggled with addiction most of his adult life. Growing up his father was addicted to heroin so he was raised by his mother and grandfather. He finished high school and continued into schooling for hotel management where he was eventually let go due to his addiction. In 2010 he came to Canada through arranged marriage and continued using drugs and alcohol even while caring for his young child. Him and his family kept his addiction hidden for a very long and faced with losing his family and his home he tried to get sober on his own but could not succeed. Eventually he used the supports in the community to find Simon House Recovery Centre and going through the 12 steps found freedom from bondage. He is now a loving father and husband working full time in the hospitality in
Mark Neufeld Police Chief Calgary Dale Mcfee Police Chief Edmonton Dean Lagrange Police Chief Camrose Michael Worden Police Chief Madison Hat
Law enforcement responds to behavioural health crisis calls every day. Recovery Oriented Policing can be a key systems navigator for people who experience mental health and substance-use related health emergencies. A panel of Police Chiefs discuss building a system with what their jurisdictions have and approaching reforms from the lens of recovery-oriented systems of care domains.