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SHOW NOTES
Summary
What does it take for people struggling with opioid use disorder to achieve recovery?
And what does “recovery” mean to each person?
In this episode of Addiction Practice Pod, addiction physician Dr. Christy Sutherland, journalist David Ball and their guests talk about the different ways in which people who use drugs define recovery, and how clinicians can support patients in achieving their recovery goals.
Lineup
In this episode, you’ll hear:
- 2:49 – Al Fowler – Board member of BC Association of People on Opiate Maintenance
- 7:55 – Keir MacDonald – Chief Executive Officer of the Phoenix Society in Surrey, BC
- 16:07 – Dr. Karen Urbanoski – Assistant Professor of Public Health and Social Policy at University of British Columbia, and Canada Research Chair in Substance Use, Addictions and Health Services Research
Pearls
Here’s what listeners can take away from this episode:
- There is no one-size-fits-all solution to problematic substance use. There are a range of definitions of what recovery means, but what they all have in common is well-being, a connection with community, and meeting a person’s goals.
- Recovery is an ongoing process that requires ongoing support. It’s great to check in with patients about how their recovery is going, especially during stressful times.
- Acute withdrawal management (“detox”) is just one step in recovery. It, alone, is not addiction treatment. Acute withdrawal management ensures that patients are medically safe while cutting down on or ceasing substance use and helps them establish a connection to care. For some patients, attending an in-patient program is a helpful step. But when they leave an inpatient program, they’re continuing an ongoing process of substance use care and support for recovery that can include a therapeutic dose of Opioid Agonist Treatment, access to harm reduction services and naloxone, and education about the high opioid overdose risk after a period of abstinence.
- Recovery can be an incremental process consisting of many small steps. It is important as a clinician to support patient-centred goals, and to not pressure people do more. There are many paths to recovery and many unique patient needs to be supported, including catching up on any primary care issues that have not been addressed. Celebrate all the small victories with patients along the way, such as improved relationships, housing, health, and what brings them joy.
Resources
Organizations
- BC Association of People on Opiate Maintenance (BCAPOM)
- Phoenix Society Drug and Alcohol Recovery and Education
- Vancouver Area Network of Drug Users (VANDU)
Online learning
- BC ECHO on Substance Use (Online, interactive sessions delivered via Zoom with didactic and case-based portions; currently offering an Opioid Use Disorder series and Alcohol Use Disorder series)
- BCCSU’s Provincial Opioid Addiction Treatment Support Program (Online, self-paced, free)
- BCCSU’s Addiction Care and Treatment Online Certificate (Online, 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 High-Risk Drinking and Alcohol Use Disorder [Internet]. 2020.
Articles
- Hurd YL, Spriggs S, Alishayev J, Winkel G, Gurgov K, Kudrich C, et al. Cannabidiol for the reduction of cue-induced craving and anxiety in drug-abstinent individuals with heroin use disorder: a double-blind randomized placebo-controlled trial. Am J Psychiatry. 2019;176(11):911–22.
- MacKinnon, K, Pauly, B, Shahram, S, Wallace, B, Urbanoski, K, Gordon, C et al. Health equity-oriented approaches to inform responses to opioid overdoses: a scoping review protocol. JBI Database of Syst Rev Implement Rep. 2019; 17(5): 640-653.
- Meier PS, Barrowclough C, Donmall MC. The role of the therapeutic alliance in the treatment of substance misuse: a critical review of the literature. Addiction. 2005;100(3):304-316.
- McPherson, C, Boyne, H, Willis, R. Understanding the factors that impact relapse post-residential treatment, a six-month follow-up from a Canadian treatment centre. J Alcohol Drug Depend. 2017;5(3).
- McQuaid, R, Malik, A, Moussouni, K, Baydack, N, Stargardter, M, & Morrissey, M. (2017). Life in recovery from addiction in Canada [Internet]. Ottawa: Canadian Centre on Substance Use and Addiction; 2017. 79 p.
- Rush, B, Urbanoski, K. Seven Core Principles of Substance Use Treatment System Design to Aid in Identifying Strengths, Gaps, and Required Enhancements. J Stud Alcohol Drugs. Supplement 2019; s18:9-21.
- Spithoff, S, Meaney, C, Urbanoski, K, Harrington, K, Que, B, Kahan, M, et al. Opioid agonist therapy during residential treatment of opioid use disorder. Can Fam Physician. 2019; 65(10):e443-e452.
- Urbanoski, K, Kenaszchuk, C, Inglis, D, Khobzi Rotondi, N, Rush, B. A System-Level Study of Initiation, Engagement, and Equity in Outpatient Substance Use Treatment. J Subst Abuse Treat. 2018;90:19-28.
Additional resources
- 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. Opioids: A survivor’s guide [Internet]. Vancouver: BCCSU; 2019.
Banner photo by Hannah Busing on Unsplash.