Exploring ROSC in the Doctor’s Office

Room – Stephen Room February 21st, 2023, Two-Part Panel, Part 1 – 11:00 am to 12:30 pm, Part 2 – 1:30 pm to 3:00 pm, Hyatt Regency Centre, Calgary Alberta.

Speakers

  • Dr Jenny Melamed
  • Dr John Koehn
  • Dr Paul Sobey
  • Dr Nathaniel Day
Alberta Recovery Conference
Recovery Capital Conference

Session Description

Dr. Jenny Melamed, Alliance clinic is a full service addiction clinic. I will describe how we treat addiction in a biopsychosocial model incorporating a treatment team of therapists and include ministry, parole officers and encourage attendance at mutual support meetings. We do not provide PSAD. Patients are supported in their journey including those that, once they are stable, want to wean off MOUD.

Dr. John Koen, This part of the session will explore a regional response in BC to the increased demand for addiction and overdose prevention services both in the hospital and outpatient settings. We will examine the successes and challenges of the Rapid Access Addiction Clinic (RAAC) model and the lessons learned.

Dr. Paul Sobey, The medical community is unfamiliar with the ROSC construct. Doctors are busy. Many are burned out and most are working in silos of care. A ROSC is exactly what this doctor would order. Doctors who can engage their local ROSC will experience a personal therapeutic benefit and find some of their most difficult patients easier to manage as well. In this brief presentation, I will discuss how the recovering community and office-based doctors can effectively engage each other.

Dr. Nathaniel Day, This presentation will review Alberta’s response to opioid addiction and overdose, including some latest information about VOPD and lessons learned about the importance of rapid access. This session will also discuss unintended consequences to the health system and to patient or client outcomes when we do or don’t focus on individual needs and recovery goals.

Learning Objective

  • Demonstrate the importance of a therapeutic alliance and show how MOUD is but one arm of recovery
  • To gain perspective on the regional response to increased demand for addiction medicine and substance use services in BC’s largest health authority
  • To appreciate the complexity of and the factors involved in establishing ROSC within the acute care hospital setting
  • To examine the successes and challenges of the Rapid Access Addiction Clinic model of care
  • Be familiar with and able to apply scientific research into an assertive referral to community mutual help groups
  • Be familiar with appropriate language to approach doctors about ROSC and the language doctors can use to effectively communicate with the recovering community
  • Be familiar with and able to use screening instruments to measure Recovery Capital in patients
  • Be familiar with how an office-based doctor can most effectively play a role in a local ROSC
  • Participants will understand the changes that have improved care in Alberta, and the motivations behind the changes and will be inspired to take a changing lens back to their programs and communities.
  • Participants will learn about the value of a systems approach and will be more aware of the importance of physician collaboration in opioid addiction.

References

  • Kelly, John. A US national randomized study to guide how best to reduce stigma when describing drug-related impairment in practice and policy. Addiction. 2021 Jul;116(7):1757-1767.
  • Romo, Lynsey K. “Coming out” as an alcoholic: how former problem drinkers negotiate disclosure of their nondrinking identity. Health Communication Volume 31, 2016 – Issue 3.
  • Leamy, Mary, Conceptual framework for personal recovery in mental health: a systematic review and narrative synthesis. The British Journal of Psychiatry (2011)199, 445–452.
  • Manning, Victoria. Does active referral by a doctor or 12-Step peer improve 12-Step meeting attendance? Results from a pilot randomized control trial. Drug and Alcohol Dependence 126 (2012) 131– 137.
  • McLellan, Thomas. Five-year outcomes in a cohort study of physicians treated for substance use disorders in the United States. BMJ 2008;337:a2038.
  • Shanks, Vicki. Measures of Personal Recovery: A Systematic Review. Psychiatric Services. October 2013 Vol. 64 No. 10
  • Day, N., Wass, M. & Smith, K. Virtual opioid agonist treatment: Alberta’s virtual opioid dependency program and outcomes. Addict Sci Clin Pract 17, 40 (2022). https://doi.org/10.1186/s13722-022-00323-4
  • Public Health Agency of Canada. Opioid-related Harms in Canada. Ottawa: 2020. Health-infobase.canada.ca. https://health-infobase.canada.ca/substance-related-harms/opioids
  • Volkow ND, Frieden TR, Hyde PS, Cha SS. Medication-assisted therapies–tackling the opioid-overdose epidemic. N Engl J Med. 2014;370(22):2063–6. https://doi.org/10.1056/NEJMp1402780.
  • Tofighi B, Williams AR, Chemi C, Suhail-Sindhu S, Dickson V, Lee JD. Patient barriers and facilitators to medications for opioid use disorder in primary care. Subst Use Misuse. 2019;54(14):2409–19.
  • Patel K, Bunachita S, Agarwal AA, Lyon A, Patel UK. Opioid use disorder: treatments and barriers. Cureus. 2021;13(2):e13173. https://doi.org/10.7759/cureus.13173.

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Alberta model

https://www.caccf.ca/recovery-capital/

a $600 CACCF Value