Pictured above: CAMH Chief of Medicine in Psychiatry, Dr. Peter Selby
The years-long opioid crisis in Canada shows no signs of slowing down.
Last year was the worst on record, with 4,460 overdose deaths—one every two hours.
Everyone on the front lines agrees that more coordination and cooperation among all stakeholders is essential to saving more lives. When the College of Physicians and Surgeons of Ontario decided it needed to expand the scope of its annual conference on Opioid Use Disorder to include more partners, they turned to CAMH.
“They came to us because they saw us playing a partnership role in the education aspect of the opioid crisis,” said Asha Maharaj, CAMH Director of Community and Continuing Education. “We believe better outcomes can be achieved when you take a 360 degree approach to the opioid crisis, so we involved pharmacists, social workers, police officers, physicians and the voices of people with lived experience in the planning of this conference.”
One of those voices was Holly Raven, 34, who struggled with opioid use disorder for 14 years, all of them taken as prescribed by a doctor, in part because of lingering soreness in her knee from playing high school volleyball.
For many of those years, as her tolerance for opioids increased and she craved higher doses, she went to several doctors to get more prescriptions and several pharmacists to get them filled. Currently in recovery in a methadone and suboxone treatment program, she welcomed the opportunity to tell her story in a panel session with her current doctor.
“Doctors need to know what we go through after they prescribe opioids,” she said. “I think that is absolutely essential.”
Previously called the Ontario Methadone Prescribers’ Conference, the renamed Opioid Use Disorder in Primary Care Conference took place this past Friday in advance of National Addictions Awareness Week and included discussions of specialized treatment approaches for older and marginalized patients, as well as those also dealing with concurrent disorders, polysubstance use and acquired brain injuries.
The conference builds on CAMH’s already-established involvement in methadone prescribing. Every doctor in Ontario who prescribes methadone for opioid use disorder has been trained by CAMH, as has every pharmacist who dispenses methadone. Other CAMH-led initiatives include an Opioid De-implementation initiative in conjunction with the Provincial System Support Program to reduce the overall amount of opioids being prescribed, a CAMH-specific Opioid Overdose Prevention Strategy to guide the hospital’s own efforts and a new training program for pharmacy students at the University of Toronto.
“CAMH continues to broaden partnerships to account for a system that has been fractured,” said CAMH Chief of Medicine in Psychiatry and Course Director Dr. Peter Selby, who gave the presentation on unique treatment considerations for patients with brain injuries dealing with addiction. “The response can’t just be in the hands of specialists. It needs to be the job of every healthcare provider to deal with this.”
Holly’s advice now for doctors thinking of prescribing opioids?
“Educate your patients. I was never told they could be addictive. It was just prescribed to me as the next step in pain relief.”
And for her younger self?
“Don’t touch them at all. Because once you get started, that’s it.”