Bringing substance use care into your primary care practice

Post-listening Survey

Thanks for listening to this episode! Our survey is now closed.

SHOW NOTES
 

Summary

Want to bring treatment for substance use disorder into your practice, but not sure where to start?

In this episode of Addiction Practice Pod, addiction physician Dr. Christy Sutherland, journalist David P. Ball and their guests talk about the nuts and bolts of integrating treatment for opioid use disorder into a family practice. They also discuss the challenges that patients face in accessing medical care, and how health care providers can help bridge that gap by building a well thought-out, compassionate practice.

 
Lineup

In this episode, you’ll hear:

• 3:20 – Dr. Michelle Brousson – Medical doctor with HealthConnection Clinic in North Vancouver, British Columbia, and a past presenter on the BC ECHO on Substance Use
• 13:55 – Charlene Burmeister – Provincial Peer Coordinator for the Centre for Disease Control in Quesnel, British Columbia, and a member of the Northern BC Patient Safety and Quality Council

 
Pearls

Here’s what listeners can take away from this episode:

1. Opioid agonist treatments, or OAT, are high-impact interventions that a family doctor can offer. It reduces mortality and improves quality of life. Once you have a rhythm and workflow for your office, you can seamlessly incorporate OAT into your primary care clinic. You probably already have patients who would benefit from OAT. You can learn more about administering OAT in British Columbia (BC) here:
   https://www.bccsu.ca/poatsp/
2. There are specific Medical Services Plan (MSP) codes that recognize the time it takes to provide OAT and substance use care and that support family doctors in BC to do this work.
3. You can incorporate Motivational Interviewing into your skill set of clinical care. It will make your day easier. You can have collaborative conversations with your patients that evoke change and promote autonomy. There is a lot of joy in providing care to this patient population. It is very rewarding work.

 
Resources

Organizations

• HealthConnection Clinic
• BC Patient Safety and Quality Council

Online Learning 

• BC ECHO on Substance Use (Interactive sessions delivered via Zoom with didactic and case-based portions, free; currently offering an Opioid Use Disorder series and Alcohol Use Disorder series)
• BCCSU’s Provincial Opioid Addiction Treatment Support Program (Self-paced, free)
• BCCSU’s Addiction Care and Treatment Online Certificate (Self-paced, free)

Guidance

• BC Centre on Substance Use. A Guideline for the Clinical Management of Opioid Use Disorder [Internet]. 2017.
• BC Centre on Substance Use. A Guideline for the Clinical Management of Opioid Use Disorder — Youth Supplement [Internet]. 2018.
• BC Centre on Substance Use. A Guideline for the Clinical Management of Opioid Use Disorder—Pregnancy Supplement [Internet]. 2018.
• BC Centre on Substance Use. A Guideline for the Clinical Management of High-Risk Drinking and Alcohol Use Disorder [Internet]. 2020.
• BC Provincial Mental Health and Substance Use Planning Council. Trauma-Informed Practice Guide [Internet]. 2013.
• Government of British Columbia, Ministry of Health. Opioid Use Disorder – Diagnosis and Management in Primary Care [Internet]. 2018.

Articles

• Lundahl B, Burke BL. The effectiveness and applicability of motivational interviewing: a practice-friendly review of four meta-analyses. J Clin Psychol. 2009;65(11):1232-1245.
• Lundahl B, Moleni T, Burke BL, Butters R, Tollefson D, Butler C et al. Motivational interviewing in medical care settings: A systematic review and meta-analysis of randomized controlled trials. Patient Educ Couns. 2013;93(2):157-168.
• Rollnick S, Miller WR. What is Motivational Interviewing? Behavioural and Cognitive Psychotherapy. 1995;23(04):325-334.
• Smedslund G, Berg RC, Hammerstrom KT, Steiro A, Leiknes KA, Dahl HM et al. Motivational interviewing for substance abuse. Cochrane Database of Systematic Reviews 2011 Issue 5. No.: CD008063.
• VanBuskirk KA, Wetherell JL. Motivational interviewing with primary care populations: a systematic review and meta-analysis. J Behav Med. 2014;37(4):768-780.

Additional Resources

• The BC Centre on Substance Use (BCCSU)’s ‘Opioid Use Disorder’ page contains links to screening tools, FAQs, forms, and up-to-date bulletins on new treatment approaches
• The Rapid Access to Consultative Expertise (RACE) line mentioned by Dr. Brousson, through which practitioners can speak directly to an addiction medicine specialist for advice, is available Monday to Friday between 8am and 5pm Pacific time
• The 24/7 Addiction Medicine Clinician Support Line provides telephone consultation around the clock to health personnel who are involved in addiction and substance use care and treatment in BC
• BC Centre on Substance Use. FAQ: Pandemic Prescribing in the context of Dual Public Health Emergencies [Internet]. Vancouver (BC): BCCSU [2020].
• BC Centre on Substance Use. New fee codes for the clinical management of opioid use disorder [Internet]. Vancouver (BC): BCCSU [2018].
• Canadian Centre on Substance Use and Addiction. What is Motivational Interviewing? Ottawa (ON): Canadian Centre on Substance Use and Addiction [2017].