In this edition: Buprenorphine XL, provincial Youth Wellness Hubs, how empathy improves patient outcomes.

In this edition: Contigency Management in RAAM clinic, alcohol withdrawal in EDs, working towards sobriety, primary care crisis.

META:PHI March webinar presented by Dr. Tany Hauck and Stephanie Rochon

In this edition: interprofessional collaboration, Hep C mobile care and more

In this edition: Auto micro-induction of buprenorphine XL, relationship-building as crucial as methadone, unique opioid stewardship program, and musings on the meaning of harm reduction.

In this edition: Thoughts from a semi-retired addiction doctor; mobile crisis intervention program; shocking stats on OAT initiation after ED visits; one journey of addiction and recovery.

Happy new year!

META:PHI is very excited to announce the release of several new resources:

• Recommendations for the use of slow-release oral morphine as opioid agonist therapy: Bringing together published evidence and both clinical and experiential expertise, these recommendations are intended to guide prescribers in the use of slow-release oral morphine (SROM, brand name Kadian) as opioid agonist therapy (OAT).
• Slow-release oral morphine as opioid agonist therapy: Plain language summary: A summary of the recommendations, intended for patients interested in learning about SROM as OAT.
• Opioid agonist therapy decision aid tool: A tool for patients to use with their health care providers to help them decide what opioid agonist therapy (OAT) option would be best for them: sublingual buprenorphine (Suboxone), depot buprenorphine (Sublocade), methadone, or slow-release oral morphine (Kadian).
• Toolkit for alcohol-related presentations to the emergency department: This toolkit was created for clinicians working in the emergency department (ED). These tools address the effective treatment of alcohol withdrawal, management of other alcohol-related presentations, brief counselling interventions, initiation of anti-craving medications, and referral to community resources.

All of these documents can be downloaded from our Resource Library.

We have recently produced a set of documents outlining a new framework for making decisions about take-home doses of methadone:

• A new framework for methadone carries: A person-centered evidence-informed approach to methadone take-home “carry” dosing: This document brings together evidence, experiential expertise, and clinical expertise to propose a framework for making decisions about take-home methadone doses
• A new approach to methadone carries: Plain-language summary: A summary of the approach, aimed primarily at people taking methadone
• A new approach to methadone carries: One-page handout: An infographic poster/handout that gives an overview of the approach and links to the full document and the summary

All of these documents can be downloaded from our Resource Library.

Two new generic methadone products have been added to the Ontario provincial formulary. As of September 29th, only the equivalent cost of generic methadone will be reimbursed by the province. META:PHI undertook a consultation process to produce information sheets on this change for people on methadone and for health care providers.

Many thanks to the individuals who contributed to these documents:

Jennifer Brasch, Lisa Bromley, Chris Cavacuiti, Katie Dunham, Laura Jones,  Robyn Kalda, Suzanne Latreille, Andrew McLeod, Charlotte Munro, Rebecca Penn, Lori Regenstreif, Cassandra Schuck, Elizabeth Shouldice, Ashley Smoke, Lorilee Steadman, Jasen Szabo, Maria Zhang

These materials are intended for EDs and hospitals who want to set up their own take-home naloxone programs, in collaboration with the Ontario Naloxone Program and local public health units.

Steps for building a take-home naloxone program in the ED

ED Primer for take-home naloxone

Pamphlet – 5 Steps to Save a Life