Dr. Evan Wood spoke at the 20th Canadian Collaborative Mental Health Care Conference #ccmhc2019 in Richmond on strategies to optimize substance use care and treatment in British Columbia.
Dr Wood’s keynote aimed to recognize structural reasons for stigma and poor trust of the health system among persons with addiction; Recognize challenges with receiving evidence-based care for concurrent medical and mental health conditions for persons who use drugs; and Improve understanding of health system delivery of evidence-based care for persons with addiction. Dr Wood shared six areas in need of implementation and lessons learned.
May 10| Sheraton Vancouver Airport Hotel | Richmond BC
1 How did we get here? Criminalization and illegality of drugs has created this tremendous windfall for organized drugs.
2 Addiction treatment is not simple. There are no silver bullets. There are evidence based strategies to treat mental illness. Trazadone probably increases the use of alcohol in the addiction treatment context.
3 There are tremendous implementation gaps when we can make impact. Do we need a harm reduction program for our harm reduction program? Why do overdoses remain so elevated?
4 Coming from prison, detox – means increased risk for overdose. Primary care based addiction medicine continuum of care needed from acute presentations, withdrawal management OAT and recovery services.
5 Get your drugs checked. Overdose deaths are a poisoning issue. Regulated opioids can displace use of toxic drugs while engaging in treatment. Drug testing should be expanded to bring accountability to drug market. Overall focus on drug supply needed. There are so many harms of prohibition – legalization and regulation reduce those harms. But we need to work very hard to build a mental health and substance use care system.
6 Fentanyl is a consequence of drug prohibition. Paradigm shift focusing resources on evidence-based public health, prevention, treatment and recovery needed.
Recovery is critically important. The private recovery system in BC needs to be regulated. Training is one solution. Focus on safe drug supply. Move towards a public health focus.
Interprofessional/intersectoral teams, family physicians and other primary care providers, mental health care providers, psychiatrists and psychologists, administrators and policy makers, other health disciplines working with primary care and/or community care, consumers and family members, educators and their students, and researchers attended the conference. To learn more about the 20th Canadian Collaborative Mental Health Care Conference visit https://ubccpd.ca/course/CCMHC2019