Marshall Smith, Chief of Staff to the Premier of Alberta. Tom Coderre, Acting Principal Deputy Assistant Secretary SAMHSA
April 3rd, 3:30 pm to 5:00 pm
Main Exhibition Hall – TELUS Convention Centre Calgary
About this Session – Leadership In Recovery
Canada’s largest addiction recovery healthcare conference will host a talk about leadership in transforming complex healthcare systems. Marshall Smith and Tom Coderre will focus on two key learning objectives. Firstly, participants will gain a deeper understanding of the essential qualities and skills required for effective leadership in the context of addiction recovery and healthcare systems. This will include exploring strategies for navigating the complexities of healthcare systems, fostering collaboration among stakeholders, and advocating for policy changes that support recovery-oriented care. Secondly, attendees will learn practical techniques for implementing and sustaining transformative changes within healthcare systems to better support individuals in their recovery journey. This will involve discussing innovative approaches, such as integrated care models, peer support programs, and the use of technology, to improve access, quality, and outcomes in addiction recovery services.
The Virtual Opioid Dependency Program and Recovery Capital
About this session – Dr J Stryder ZoBell
The Virtual Opioid Dependency Program (VODP), which began in 2018, is a provincial-wide program specializing in assessing, treating, educating, and stabilizing individuals who struggle with substance use disorders. We aim to present the work of VODP which has utilized medications, counseling, motivational interviewing, and innovative techniques in order to initiate individuals and maintain them on their recovery journey. Significantly, the VODP has expanded to address the needs of specific demographics, particularly adolescents and young adults, who are increasingly at risk for opioid use disorder. In 2022, the program established the Youth VODP (yVODP), a specialized team focused on this vulnerable population. Our presentation will delve into the operations of yVODP, emphasizing its strategies in managing opioid use disorder among adolescents. We will explore the treatment modalities, community involvement, and collaborative efforts that underpin the success of this targeted intervention
Learning Objectives
Individuals will have a further understanding of differing opioid agonist therapy medication options, the efficacy of these different medications in recovery, a deeper understanding into the unique challenges of differing population subsets struggling with opioid use disorder, as well as a deeper understanding of the VODP as a provincial support for those individuals struggling with substance use disorder.
References
Ray LA, Meredith LR, Kiluk BD, Walthers J, Carroll KM, Magill M. Combined Pharmacotherapy and Cognitive Behavioral Therapy for Adults With Alcohol or Substance Use Disorders: A Systematic Review and Meta-analysis. (2020)
Day N, Wass M, Smith, K. Virtual opioid agonist treatment: Alberta’s virtual opioid dependency program and outcomes. (2022)
Nairn SA, Audet M, Stewart SH, Hawke LD, Isaacs JY, Henderson J, Saah R, Knight R, Fast D, Khan F, Lam A, Conrod P. Interventions to Reduce Opioid Use in Youth At-Risk and in Treatment for Substance Use Disorders: A Scoping Review. Can J Psychiatry. 2022
About this session – Dr Hussain Aboud
The Virtual Opioid Dependency Program (VODP), which began in 2018, is a provincial wide program specializing in assessing, treating, educating, and stabilizing individuals who struggle with substance use disorders. We aim to present the work of VODP which has utilized medications, counseling, motivational interviewing, and innovative techniques in order to initiate individuals and maintain them on their recovery journey.
Significantly, the VODP has expanded to address the needs of specific demographics, particularly adolescents and young adults, who are increasingly at risk for opioid use disorder. In 2022, the program established the Youth VODP (yVODP), a specialized team focused on this vulnerable population. Our presentation will delve into the operations of yVODP, emphasizing its strategies in managing opioid use disorder among adolescents. We will explore the treatment modalities, community involvement, and collaborative efforts that underpin the success of this targeted intervention
Learning Objectives
Individuals will have a further understanding of differing opioid agonist therapy medication options, the efficacy of these different medications in recovery, a deeper understanding into the unique challenges of differing population subsets struggling with opioid use disorder, as well as a deeper understanding of the VODP as a provincial support for those individuals struggling with substance use disorder.
References
Ray LA, Meredith LR, Kiluk BD, Walthers J, Carroll KM, Magill M. Combined Pharmacotherapy and Cognitive Behavioral Therapy for Adults With Alcohol or Substance Use Disorders: A Systematic Review and Meta-analysis. (2020)
Day N, Wass M, Smith, K. Virtual opioid agonist treatment: Alberta’s virtual opioid dependency program and outcomes. (2022)
Nairn SA, Audet M, Stewart SH, Hawke LD, Isaacs JY, Henderson J, Saah R, Knight R, Fast D, Khan F, Lam A, Conrod P. Interventions to Reduce Opioid Use in Youth At-Risk and in Treatment for Substance Use Disorders: A Scoping Review. Can J Psychiatry. 2022
Bio
Dr Hussain Aboud CCFP AM, ISAM, ACBOM is an addiction medicine physician and clinical lead for the youth program at the virtual opioid dependency program in Ponoka, Alberta. With a dynamic career spanning over 20 years as a family physician working on the front line of the opioid epidemic, Dr. Aboud has dedicated himself to the field of addiction, recovery, and mental health. His approach is holistic and inclusive, addressing the needs of diverse groups including adults, adolescents, youth, pregnant women, and individuals in remand. This broad spectrum of care highlights his understanding of the varied facets of addiction and the unique challenges faced by different groups during their recovery journey.
Exhibition Hall C – TELUS Convention Centre Calgary
A Social Ecology Model of Recovery and Recovery Capital
About this Session
There is a long tradition within the recovery housing approach and within therapeutic communities of a ‘social model’ of recovery as promoted by Thomasina Borkman. This is based on the idea that recovery is an intrinsically social process. However, it does not adequately account for broader contextual and societal effects, including recovery visibility. The presentation will use a recovery capital framework to present a model of recovery contagion where the context is essential in creating the stage for social conditions of recovery to apply. The model will draw on the concept of Recovery-Oriented Systems of Care and the global Inclusive Recovery Cities model
Learning Objectives
1. To understand the concept of community recovery capital and its role in challenging stigma and exclusion
2. To understand and be able to articulate what an Inclusive Recovery City is and how it can be operationalized
3. To be aware of and able to cite the most recent evidence about recovery and recovery capital
References
1. Best, D. (2019) Pathways to desistance and recovery: The role of the social contagion of hope. Policy Press: Bristol. 2. Best, D. & Colman, C. (eds)(2019) Strengths-based approaches to crime and substance use: From drugs and crime to desistance and recovery. Routledge: London. 3. Best , D., Sondhi,A., Best, J., Lehmann, J. Grimes, A., Connor, M. & De Triquet, B. (2023) Using Recovery Capital to Predict Retention and Change in Recovery Residences in Virginia, USA, Alcoholism Treatment Quarterly, 41:2, 250-262 4. Best, D., Sondhi, A., Hoffman, L., Best, J., Leild, A., Grimes, A., Conner, M., DeTriquet, R., White, W., Hilliard, B., Leonard, K. & Hutchinson, A. (2023) Bridging the gap: Building and sustaining recovery capital in the transition from prison to recovery residences, Journal of Offender Rehabilitation, DOI: 1080/10509674.2023.228648. 5. Bunaciu, A., Bliuc, A-M., Best, D., Hennessy, E., Belanger, M. & Benwell, C. (2023) Measuring recovery capital for people recovering from alcohol and drug addiction: a systematic review, Addiction Research & Theory, DOI: 10.1080/16066359.2023.2245323
Bio
David Best is Professor and Director of the Centre for Addiction Recovery Research at Leeds Trinity University. He is also President of the Recovery Outcomes Institute in Florida, and an Affiliate Senior Scientist at the Public Health Institute in Caliifornia. He holds honorary professorial posts at the Australian National University and Monash University in Melbourne. He is also Chair of the Prison Research Network the British Society of Criminology. He is also extremely old and struggles to remember where he is much of the time
Accessing Addiction Treatment in First Nations with the Virtual Opioid Dependency Program
Prevalent fentanyl use has contributed to an increase in fatal opioid overdoses in Alberta. The rate of fatal overdose in First Nations people is seven times higher than in Non-First Nations people. Indeed, First Nation reserves present unique challenges to treating opioid addiction including remoteness, pharmacy availability, and access to prescribers. Yet the main treatment for opioid addiction—opioid agonist therapy (OAT)—reduces mortality by over fifty percent2. To overcome these challenges and improve access to OAT, the Virtual Opioid Dependency Program uses telehealth and a low-barrier philosophy to start and continue people on treatment3. It a province-wide program specializing in assessment, treatment, and follow-up for outpatients with opioid use disorder.
In 2022, a First Nation in Alberta experienced 25 fatal overdoses in a three-month period and approached the VODP to form a partnership. We developed a model where staff assessed and treated patients in-person on reserve with remote access to VODP physicians. My presentation will explore this model, and how we use buprenorphine based products such as buprenorphine-XR and buprenorphine/naloxone in novel ways to improve access and retention to treatment.
Alberta Opioid Response Surveillance Report: First Nations People in Alberta (2021)
Santo, Thomas Jr et al. “Association of Opioid Agonist Treatment With All-Cause Mortality and Specific Causes of Death Among People With Opioid Dependence: A Systematic Review and Meta-analysis.” JAMA psychiatry vol. 78,9 (2021): 979-993. doi:10.1001/jamapsychiatry.2021.0976
Day N, Wass M, Smith, K. Virtual opioid agonist treatment: Alberta’s virtual opioid dependency program and outcomes. (2022)
Dr Grady Gibson MD CCFP ISAM is an addiction medicine physician and the medical director for the Virtual Opioid Dependency Program. Since completing his medical training Dr. Gibson has worked in addiction-related roles including inpatient treatment, acute care consultation, and has been involved in the development and expansion of the Virtual Opioid Dependency Program. Dr. Gibson quickly moved towards providing addiction treatment in his career because he observed the powerful and life changing improvement that a person can experience from these interventions.
Dr. Paul Sobey, Elizabeth Loudon, Kristopher Liber, and Kieran Spice
Transforming Corrections: Therapeutic Living Units in the Alberta ROSC
About this Session
Therapeutic Living Units (TLUs) are Therapeutic Communities (TC) adapted for correctional facilities. TCs are a highly effective evidence-based intervention for the treatment of severe SUDs with more than 60 years of therapeutic value in communities, jails, and other settings. The presenters will discuss the unique approach taken in establishing and operating three TLUs in Alberta, the daily program, including the rationale and philosophy, and the evidence for the approach.
Learning Objectives
At the end of the presentation, the participant will:
1. Have a clear understanding of the evidence base for the TC model and its adaptation for a correctional facility.
2. Understand the unique process RSG took in standing up and operating TLUs.
3. Understand the unique program RSG developed and modifications made to achieve the best possible outcomes
References
1. De Leon, G. Is the Therapeutic Community an Evidence-Based Treatment? What the Evidence Says. In Therapeutic Communities: The International Journal for Therapeutic and Supportive Organizations (2010).Vanderplasschen W, Colpaert K, Autrique M, et al. Therapeutic communities for addictions: a review of their effectiveness from a recovery-oriented perspective. Scientific World Journal. (2013) 2013:427817. doi:10.1155/2013/427817
2. De Leon G. “The Gold Standard” and Related Considerations for a Maturing Science of Substance Abuse Treatment. Therapeutic Communities; A Case in Point. Substance use & misuse, (2015) 50(8-9):1106–1109. doi: 10.3109/10826084.2015.1012846.
3. Doyle MF, Shakeshaft A, Guthrie J, Snijder M, Butler T. A systematic review of evaluations of prison-based alcohol and other drug use behavioural treatment for men. Aust N Z J Public Health. (2019) 43(2):120-130. doi: 10.1111/1753- 6405.12904.
4. Hubbard RL, Craddock SG, Anderson J. Overview of 5-year follow-up outcomes in the drug abuse treatment outcome studies (DATOS). J Subst Abuse Treat. 2003;25:125 – 134.
5. Prendergast LM, Hall AE, Wexler KH, Melnick G, Cao Y. Amity Prison-Based Therapeutic Community: 5-Year Outcomes. Prison Journal (2004) 84(1):36-60. https://www.ojp.gov/library/publications/amity-prison-based-therapeutic- community-5-year-outcomes
6. Rowan M, Poole N, Shea B. et al. Cultural interventions to treat addictions in Indigenous populations: findings from a scoping study. Subst Abuse Treat Prev Policy 9, 34 (2014). https://doi.org/10.1186/1747-597X-9-34
7. Gress CLZ, Arabsky S. Nanaimo Correctional Centre Therapeutic Community Preliminary Impact Analysis: British Columbia: Ministry of Public Safety and Solicitor. (2010). https://www2.gov.bc.ca/assets/gov/law-crime-and- justice/criminal-justice/corrections/research-evaluation/ncc-tc-pia.pdf
Bio
Dr. Sobey’s background is in Family Practice. He completed fellowship training in Addiction Medicine at University Hospitals of Cleveland and Case Western Reserve University in 1999. Since this time, he has focused his practice on the treatment of patients with addictions. He has had the honour and opportunity to work extensively in educational, residential treatment, hospital and correctional facility settings, as well as medical-legal, occupational, hospital and administrative roles. He is a past President of the Canadian Society of Addiction Medicine, the nationally representative organization for physicians and allied healthcare professionals providing healthcare services for people with addictions. Given he is a person in long term recovery, his practice has always had a recovery medicine focus, assisting people in finding pathways of recovery. In December 2022, two colleagues and Dr. Sobey formed ROSC Solutions Group. After a competitive bid process, RSG was awarded several healthcare contracts by the Government of Alberta. The contract’s scope of work is focused on supporting Alberta’s Recovery Oriented System of Care in addressing addiction and mental health challenges.
Day 1 – 11:00 am to 12:30 pm Bannerman Walker Room
Recovery communities (RCs), also known as therapeutic communities, are a type of long-term residential treatment for addiction that emphasizes the importance of a holistic approach. RC’s aim is to treat the affected individual as a whole while examining the underlying mechanisms and individual causes of addiction. Further, RCs focus on creating positive lifestyle changes and bolstering recovery capital in order to facilitate sustained recovery. RCs are rooted in evidence-based practices and rely on measurement-based care to guide treatment. RCs draw upon the resilience of communities to not only enable recovery but also improvements in overall well-being and functioning. Moreover, RCs aim to promote recovery by establishing a shared vision and commitment to recovery over the long term.
This session will delve more deeply into the clinical relevance of treatment in RCs in general. Strategies to increase treatment accessibility and recovery capital will be discussed. Specifically, the admission process into Alberta’s inaugural therapeutic community, the Red Deer Recovery Community by EHN Canada, will be explained to facilitate access to these treatment spaces, which are fully funded by the Alberta Government. Finally, research findings on the clinical outcomes of over 700 former inpatients will be presented along with perceived barriers to measurement-based care and how they can be addressed.
The following presentation will address:
The importance and clinical relevance of treatment in Recovery/Therapeutic Communities
Treating underlying causes and setting up residents with extensive recovery capital through long-term treatment
Getting to the root of trauma and truly addressing issues
Using evidence-based practices, and research measures, to show the efficacy of treatment
Alberta Recovers
Why this model is so relevant for Canada and how private and public healthcare can work together
Making treatment accessible
Presentation of research findings from 700+ patients over the past three years on their recovery journey; what works, what clinicians find most relevant, and what we need to do better.
Room – Main Ballroom 3:30 pm February 22nd, 2023, Hyatt Regency Centre, Calgary Alberta
Speaker – Dr Julian M Somers
Session Description
This talk will look back in order to look forward, and describes opportunities to end tensions that have formed between sectors identified with Harm Reduction and Addiction Recovery respectively.
Methadone maintenance therapy emerged in North America in the 1950s, leaving an indelible mark on public addiction treatment. The first research publications appeared a few years later and described programs operating independently in New York and Vancouver. Despite their separate origins the two programs were remarkably similar with respect to the people they served (referred to by both teams as “addicts”), their modest inclusion of methadone, and the importance they placed on long-term supports capable of helping “addicts” to reintegrate into society.
By the 1980s public addiction treatment was woefully insufficient in many countries, causing drug users to band together and help one another. Harm Reduction emerged from the Dutch Junkiebond and contemporaneous groups elsewhere in Europe and North America. These groups emphasized opportunities to reduce harms caused by drugs and by policies under the War on Drugs. AIDS and other ensuing forces caused harms to multiply, and the practice of Harm Reduction was preoccupied by mitigating their proliferation.
New writing on addiction offers a conceptual opportunity to align Harm Reduction and Addiction Recovery in the service of long term person-centred goals. This new writing evokes some of the same themes that guided early methadone programs, but also incorporates crucial lessons learned in ensuing years. The result is an opportunity for Harm Reduction and Addiction Recovery to bring out the best in each other so that we might all be our best for those we aim to help.
Learning Objectives
Know the origins of effective methadone maintenance therapy and its inclusion of practices that reduce harms and promote recovery from addiction.
Know major reasons for the current rift between services associated with harm reduction and addiction recovery respectively.
Know major recent developments that create opportunities for unification among people who wish to help those who struggle with addictions.
References
Davidson L, Rowe M, DiLeo P, Bellamy C, Delphin-Rittmon M (2021). Recovery-oriented systems of care: a perspective on the past, present, and future. Alcohol Research 41(1):09
Dole VP, Nyswander ME & Warner A (1968). Successful treatment of 750 criminal addicts. JAMA 206(12) 2708-2711
Marlatt GA (1996). Harm reduction: come as you are. Addictive Behaviors 21(6):777-788
Room – Main Ballroom 4:00 pm February 22nd, 2023, Hyatt Regency Centre, Calgary Alberta
Speaker Dr Anna Lembke
Session Description
Stanford psychiatry professor Anna Lembke—New York Times bestselling author of Dopamine Nation: Finding Balance in the Age of Indulgence—decodes complex neuroscience into applicable strategies that explain and promote recovery. An expert in treating addictions of all kinds, in this talk Lembke discusses the biology and psychology of radical honesty: Telling the truth in all things large and small. She illuminates how radical honesty strengthens the prefrontal cortex, engenders a plenty-mindset, and ends the cycle of destructive shame that perpetuates addiction. Drawing on lessons from scientific research as well as the lived experience of people in recovery, students will learn how honesty as a daily commitment can help curb desire and encourage contentment and connectedness.
Learning Objectives
Explain the discipline of radical honesty (telling the truth in all things) and its relationship to the prefrontal cortex
Identify the role of radical honesty in promoting a plenty mindset as opposed to a scarcity mindset.
Review how radical honesty with the intention of making amends promotes intimacy and ends the cycle of destructive shame that perpetuates addiction.
References
Ahmed, S. H., and G. F. Koob. “Transition from Moderate to Excessive Drug Intake: Change in Hedonic Set Point.” Science 282, no. 5387 (1998): 298–300. https://doi.org/10.1126/science.282.5387.298.
Michel André Maréchal, Alain Cohn, Giuseppe Ugazio, and Christian C. Ruff, “Increasing Honesty in Humans with Noninvasive Brain Stimulation,” Proceedings of the National Academy of Sciences of the United States of America 114, no. 17 (2017): 4360–64, https://doi.org/10.1073/pnas.1614912114.
Volkow, N. D., J. S. Fowler, G-J. Wang, and J. M. Swanson. “Dopamine in Drug Abuse and Addiction: Results from Imaging Studies and Treatment Implications.” Molecular Psychiatry 9, no. 6 (June 2004): 557–69. https://doi.org/10.1038/sj.mp.4001507.
Bio
Anna Lembke, MD is a professor of psychiatry at Stanford University School of Medicine and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic. A clinician scholar, she is the author of more than a hundred peer-reviewed publications, has testified before the United States House of Representatives and Senate, has served as an expert witness in federal and state opioid litigation, and is an internationally recognized leader in addiction medicine treatment and education.
In 2016, she published Drug Dealer, MD – How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop (Johns Hopkins University Press, 2016), highlighted in the New York Times as one of the top five books to read to understand the opioid epidemic (Zuger, 2018).
Dr. Lembke appeared in the Netflix documentary The Social Dilemma, an unvarnished look at the impact of social media on our lives. Her latest book, Dopamine Nation: Finding Balance in the Age of Indulgence (Dutton/Penguin Random House, August 2021) was an instant New York Times and Los Angeles Times bestseller and has been translated into 25 languages. It combines the neuroscience of addiction with the wisdom of recovery to explore the problem of compulsive overconsumption in a dopamine-overloaded world.
