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The META:PHI care pathway

The goal of the META:PHI care pathway is a fully integrated system in which patients 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 referred to a rapid access addiction medicine (RAAM) clinic, which they can attend without a booked appointment or formal referral note.
  • At the RAAM clinic, an addiction specialist immediately provides brief counselling, prescribes appropriate addiction medications (such as buprenorphine, naltrexone, or acamprosate), and connects patients to community treatment programs.
  • Once patients are stabilized, they are referred back to primary care for long-term follow-up.
  • The RAAM clinician 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.
A diagram of the META:PHI model: At the centre is a green circle labeled "People who use substances". Arrows connect this circle to three dark blue circles surrounding it, labeled "RAAM clinic", "Emergency department" and "Primary care", indicating that people can present to any of these settings to receive care. These dark blue circles are connected to each other with bi-directional arrows, indicating that people can move between these settings as appropriate, with communication between them. The dark blue circles also have arrows pointing towards an outer teal ring that connects seven teal circles, labeled "Community addiction clinics", "Withdrawal management services", "Inpatient hospital units", "Mental health services", "Community services", "Residential treatment programs", and "Harm reduction services". This indicates that people should be referred to these services in accordance with their needs, goals, and preferences.