META:PHI was initially funded in 2015 by the Adopting Research to Improve Care (ARTIC) program as a pilot project to support the roll-out of rapid access addiction medicine (RAAM) clinics in seven sites across Ontario. Following the success of this initiative, the team received two subsequent grants to support the spread of the RAAM model: one from the Toronto Central Local Health Integration Network (LHIN) to implement the model in Toronto hospitals, and a secondary spread grant from ARTIC to promote the model province-wide. Since 2020, the META:PHI program has been funded by the Ontario Ministry of Health to support the province’s addiction medicine system in the following strategic priority areas:
Our Mission
META:PHI promotes the delivery of high-quality care for people who use substances through education and clinical guidance, RAAM clinic oversight, and health system integration and advocacy.
Our Vision
Integrated, appropriate, low-barrier, and equitable health care for people who use substances.
Strategic Priorities
Networking and integration
Help develop and strengthen care pathways for people who use substances by supporting integration of services between RAAM clinics, hospitals, primary care, and community-based services.
Facilitate collaboration among the partners involved in care for people who use substances, including policy makers, health agencies, harm reduction and treatment services, and people with lived experience.
Maintain a community of practice related to substance use practice and policy and facilitate networking among individuals and programs that support people who use substances.
RAAM clinic support
Develop quality targets and materials to support RAAM clinic practice.
Conduct annual survey and generate provincial report to support ongoing quality improvement.
Advocate on behalf of RAAM clinics.
Education and clinical guidance
Create clinical tools, guidelines, and practice resources that facilitate the provision of evidence-informed, person-centred substance use–related care across care settings.
Create learning opportunities such as webinars, case discussions, and an annual conference.
Incorporate perspectives of community members with lived and living experience of substance use into clinical tools and materials.
Mentorship
Facilitate opportunities for mentorship and collaboration among service providers and administrators working in substance use settings.
Facilitate mentorship opportunities on integrating substance use care into general care settings.
Policy and advocacy
Influence provincial policies concerning the structure and delivery of health services for people who use substances.
Advocate for low-barrier, appropriate, integrated, and flexible services for people who use substances.
META:PHI was initially funded in 2015 by the Adopting Research to Improve Care ARTICprogram. Following a randomized controlled trial that showed that people who were offered immediate, facilitated access to addiction medicine services were significantly more likely to start treatment and had fewer emergency department visits than those receiving usual access to care, META:PHI was funded as a pilot project to support the roll-out of rapid access addiction medicine (RAAM) clinics in seven sites across Ontario.
After this first grant, the team received two subsequent grants to support the spread of the RAAM clinic model: one from the Toronto Central Local Health Integration Network (LHIN) to implement the model in four Toronto hospitals, and a secondary spread grant from ARTIC to promote the model province-wide.
Since 2020, the META:PHI program has been funded by the Ontario Ministry of Health to provide oversight and support to publicly funded RAAM clinics, which have continued to expand across the province.
Program Structure and Governance
META:PHI is led by a core team of seven individuals, including clinicians with expertise in addiction medicine, administrators, and knowledge mobilization workers. The core team is supported by a 14-member advisory committee representing diverse geographic perspectives and professions, and regions of Ontario. The advisory committee has at minimum two individuals with lived and living experience of substance use who play an active role in decisions related to the program’s direction. META:PHI also engages with a roster of community consultants – individuals with lived and living expertise – who contribute to all of META:PHI’s educational and clinical materials and events as writers, reviewers, and speakers.
Our Team
Dr. Meldon Kahan
Medical Director
Dr. Meldon Kahan, MD CCFP FRCPC, has worked in the addiction field for many years. Recently retired from Women’s College Hospital’s Substance Use Service as Medical Director, Dr. Kahan will now be able to devote more time to his role of Medical Director at META:PHI. 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, emergency departments, and hospital units. Dr Kahan has five grandchildren and has discovered that he is a gifted story teller.
Kate Hardy
Network Director
Kate Hardy, MSW RSW MHSc, has worked at Women’s College Hospital since 2013 and helped found the META:PHI program in 2015. As director of META:PHI, Kate liaises with provincial agencies and raises the profile of the rapid access model, which has been adopted by over 70 clinics in Ontario, in addition to clinics in other provinces.
Dr. Jennifer Wyman
Clinical Program Lead
Dr. Jennifer Wyman, MD CCFP FCFP DABAM MPH, is currently an Assistant Professor in the Department of Family and Community Medicine at the University of Toronto, and Medical Director of the Substance Use Service at Women’s College Hospital in Toronto. As a physician working in primary care and addictions, in community and academic settings, her interest is in improving care pathways for people with substance use disorders through education, resource development and advocacy across the heath care sectors.
Sarah Clarke
Knowledge Broker
Sarah Clarke has been part of the META:PHI program since it began in 2015. Sarah works with people with personal and/or professional expertise in substance use to collaboratively develop educational materials and resources for health care providers with the goal of ensuring that people who use substances receive high-quality care. Sarah has a PhD in the social sciences and is currently a Master’s student in Health Systems Research.
Katie Dunham
Nursing Educator
Katie Dunham BSc Hons BScN MN NP-PHC is a primary care nurse practitioner with a background in global humanitarian aid, emergency nursing, primary-care, rapid access addiction medicine, withdrawal management in a community based live-in setting, and virtual addictions care through the Digital Front Door platform. She acts as Nurse Practitioner Lead for Stonehenge Therapeutic Community Rapid Access Addiction Medicine and is faculty at the University of Toronto Bloomberg School of Nursing. She is passionate about expanding access to substance-related care through education, and optimizing existing care pathways through community partnerships.
Leslie Molnar
Social Work Educator
Leslie Molnar, BSW MSW RSW, is a clinical social worker/psychotherapist working in the Substance Use Service at Women’s College Hospital, where she provides assessment, psychotherapy, and group experiences to patients struggling with substance use disorders. She also works in the General Psychiatry/Mental Health in Medicine program, a specialized mental health service for clients with mental health concerns complicated by a concurrent medical illness, where she delivers individual psychotherapy and facilitates a CBT group for depression and anxiety as well as a group for people who have PTSD symptoms and substance use issues. As META:PHI’s social work educator, Leslie provides educational support to social workers and outreach workers in RAAM clinics across the province. She has trained in trauma-informed care and a number of therapeutic interventions, including CBT, relational psychotherapy, DBT, structured relapse prevention, CPT, and IPT, and brings compassion and enthusiasm to her work.
Laurie Smith
Administrative Assistant
Laurie Smith has a background in teaching and music. Previous positions have included roles in education, provincial and municipal government, and healthcare. She supports the META:PHI team in their dedicated work to expand and improve access to care for people who use substances.
Advisory Committee
Dr. Jennifer Brasch
Psychiatry Advisor
Dr. Brasch is the Lead, Addiction Psychiatry, for the Mental Health & Addictions Program at St. Joseph’s Healthcare. Her clinical work includes serving as the only psychiatrist for the Concurrent Disorders Clinic at St. Joe’s, working in an opioid agonist clinic weekly and in the Rapid Access Addiction Medicine Clinic.
Dr. Brasch is a member of the Peter Boris Centre for Addiction Research and involved in projects including screening for head injuries in patients and the concurrent disorders clinic, and a meta-analysis of opioid use disorder in chronic pain patients. She is the Conference Chair and Past-President of the Canadian Society of Addiction Medicine.
Lisa Bromley
Inpatient Medicine Advisor
Dr. Lisa Bromley, MD, CCFP(AM), FCFP, is an Assistant Professor with the Faculty of Medicine at the University of Ottawa, and Medical Director of The Ottawa Hospital Substance Use Program. She works in both the inpatient and community settings. She provides low-barrier Opioid Agonist Treatment in the RAAM clinic at Sandy Hill CHC in Ottawa. She has been a methadone prescriber since 2001.
Victoria Burke
Peer Advisor
Victoria is a person with enormous wisdom and understanding of substance use that comes from her personal life history, and work experience in rural Ontario. She is the Harm Reduction and Outreach worker at a grassroots organization in Bancroft ON. She is passionate about working with other people with lived experience, and understands the complexities, the systemic oppressions and stigma – and also the hope that lay within every individual she connects with.
Robin Griller
Residential Treatment Advisor
Robin is the Executive Director of St. Michael’s Homes, an addiction and mental health service provider in Toronto. Robin has worked in a number of sectors including primary care, community social services, mental health and addictions, and health system community engagement. He has been Chair of the Addiction Service Providers Working Group in Toronto, and co-chaired the Mental Health and Substance Use Working Group for the Mid-West Ontario Health Team. As Director of Homeless and Housing Services at St. Stephen’s Community House, Robin led the founding and implementation of the Toronto Community Addiction Team, one of the first major community-hospital partnerships in the substance use service sector in Toronto. Robin has a Masters’ Degree from University of Toronto.
Pia Heikkinen
Administrator Assistant
Pia Heikkinen is Northwestern Ontario Regional RAAM Coordinator, with 23 plus years working in addiction and mental health for St Joseph’s Care Group in Thunder Bay. She is also the chair of the Northwestern Ontario Regional RAAM Steering Committee. Her variety of work experience ranges from creating and managing addiction intervention and prevention programs, to providing leadership for intensive residential addiction treatment programs. Most recently Pia has taken on the role as the lead for eight Northwestern Ontario RAAM clinic sites, helping support, coordinate and guide them in the creation and expansion of a hub and spoke model of care in the region. She is a strong advocate for Northwestern Ontario, which is characterized by a vast geographical area, scattered with small rural and remote communities. Pia brings a unique perspective to the voice of the region which is embedded in cultural safety and delivered through an equity lens.
Mae Katt
Nurse Practitioner Advisor
Mae Katt is a Primary Health Care Nurse Practitioner from Temagami First Nation and lives in Thunder Bay, Ontario. She holds an Honours degree in Nursing, Master of Education (Curriculum Specialty) and has an Honorary Doctor of Laws degree from Trent University. She coordinates a Mobile Treatment Team that provides opiate-agonist treatment with Suboxone buprenorphine-naloxone and injectable buprenorphine in remote and rural First Nations communities. For the past 20 years, Mae has provided primary care and mental health care to students in an urban based Indigenous high school.
Jean-Paul Michael
Lived Experience Advisor
Jean-Paul Michael serves as an Addiction Case Manager in the Emergency Department at St. Michael’s Hospital in Toronto, applying a harm reduction philosophy to his practice. Before dedicating himself to addiction medicine, Jean-Paul experienced two decades in the depths of his own addiction, primarily as an intravenous drug user. These experiences deeply inform both his professional role and advocacy efforts today. As a Policy Consultant, he advises various national organizations on healthcare reform and social welfare. He also co-hosts ‘Captain Hooked: The Addiction Project,’ a podcast aimed at dismantling the stigma associated with addiction. With a unique combination of professional expertise and personal history, Jean-Paul passionately advocates for reducing stigma and empowering individuals on their paths to recovery. He is also proud to serve on the Board of Directors for Fife House, actively contributing to the creation of more inclusive and supportive communities.
Adam Mcinnis
Nurse Advisor
Adam McInnis RN, BsCN, MScCH (AMH), MN NP (Student) is the Nursing Team Lead of Addiction Medicine at CMHA Thames Valley Addiction & Mental Health Services, based in London, Ontario. Adam completed his graduate studies at the University of Toronto with a Master of Science in Community Health, specializing in Addictions and Mental Health. During this time, he worked at Sherbourne Health, caring for individuals experiencing homelessness, and CAMH on the TAY/PICU Unit (Transitionally Aged Youth & Psychiatric Intensive Care Unit). Adam was recently appointed to the Mental Health & Addictions Advisory Panel (MHAAP) for the London Police Service Board. He is also working with the Centre of Excellence on the Mental Health and Addictions ‘Bed-Based Services For Substance Use’ task group. Adam combines his clinical practice, public health background and lived experience inspiring hope and change amongst his clients and colleagues in the community of London and on a provincial level.
Ainko Ramanathan
Pharmacy Advisor
Ainko Ramanathan RPh MPharm PharmD is a pharmacist from Toronto, Ontario which is where he started his journey into helping those with OUD. Having worked in different regions of Southern Ontario has given him a unique insight into the needs of this population, as well as what gaps pharmacists can fill to improve care. He then worked as a Medical Science Liaison providing indepth knowledge about extended release buprenorphine to addiction providers across Ontario while learning the needs of patients in their community. He also presented a poster at CSAM in 2022 on long-term outcomes from BUP-XR. After returning to work as a pharmacist he partnered with METAPHI to provide education to pharmacists, and will guest lecture at the University of Waterloo School of Pharmacy in their substance use course.
Ainko believes that community pharmacists are an important piece of the puzzle to address the opioid epidemic, and is keen to connect with others who believe the same.
The goal of the META:PHI care pathway is a fully integrated system in which people receive evidence-based care at every step:
Patients presenting to any health care setting – withdrawal management services (WMS), hospital, psychiatry, primary care provider – with a condition related to substance use receive highly effective, evidence-based treatment.
On discharge, patients are informed about local rapid access addiction medicine (RAAM) clinic services, which they can attend without a referral or booked appointment.
At the RAAM clinic, counselling and appropriate addiction medications are available from the first visit, and the patient can expect to be connected to relevant community programs and supports.
Once patients are stabilized, they are referred back to primary care for long-term follow-up.
The RAAM clinic provides ongoing support by being available to primary care providers for re-assessments, consultations, and advice about addiction management.
Patients move throughout the care pathway as needed, with communication between providers in the different settings.