Category: Change

Does alcohol use change after shift to Methadose?

alcohol drink, methadose
Do people drink more when they switch to Methadose? It is 10 times more concentrated than methadone –  proven treatment of opioid use disorder. We did not find more drinking after the switch. But others found changes in opioid use patterns coinciding with the change.

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We talked to 787 people receiving methadone for opioid use disorder in Vancouver, Canada.  Our new study followed them as they switched from methadone (1mg/mL) to Methadose (10mg/mL). We asked whether their drinking has changed after the switch – between 2013 and 2015. 16% said they drank too much at least once in the last six months. Those who drank too much were not more likely to do so after the shift to Methadose. The Substance Use& Misuse journal has published the study this week. 
Persons on methadone for opioid use disorder may report going through opioid withdrawal and increasing their illicit opioid use when switched to Methadose. We need to understand impacts of these changes on other forms of drug use. Careful and planned information about upcoming changes may help people cope with the potential risks better.

Conclusion

In sum, change is the law of life. Those who do not change do not survive in nature. For complex systems, such as health care, change management is the key to success. Healthy, happy and satisfied patients are healthcare’s success best proof. If they self-report negative experiences following methadone changes, their opinions should inform change management in order to build a better, patient-centered care. Their opinions, together with our findings, could help future formulary decisions in addiction treatment. Various methadone formulations may have little short-term impact on heavy alcohol use. Let’s evaluate the long-term impact.

Bring Audrey back: Teaching medical students about substance disorders

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When is the best time to teach medical students about substance related disorders?  In a new commentary published online in Annals of Internal Medicine, we bring Audrey’s story and call for better addiction medicine education for physicians.

For over 20 years at the University of British Columbia, the first year medical students have had 20 hours of teaching on the theme Addiction Medicine and Inter-collegial Responsibility which has been both highly rated by medical students and has improved their motivational interviewing.  (more…)

New article out now: Wake up the doctors and teach them addictions

Addiction medicine has been ‘practically untaught’ for decades, but that’s starting to change…
Read the full text of my recent article in the Medical Post: http://www.canadianhealthcarenetwork.ca/
Published by the Canadian Healthcare Network, The Medical Post is  “the independent newspaper and online information source for Canada’s doctors, with a 45-plus-year tradition of providing a one-of-a-kind mix of clinical updates, medico-political news and lifestyle features to assist doctors and enhance their professional and personal live.” Text taken from http://www.canadianhealthcarenetwork.ca/physicians/magazines/the-medical-post/

Random thoughts on academic mobility

What if you decide to take root, but discover a quicksand instead of a firm ground? Serendipitously, I have stumbled upon an essay about dislocation and walked into an exhibition about uprootedness on the same day.
As I wrote earlier, mobility is part of thejob description of early career academics.  A boost to the local university, economy and science are the promised trade-offs for the temporary relocation.  Few have considered the tremendous impacts that mobility has on people’s lives.

Bruce Alexander, a retired Psychology professor at Simon Fraser University in Vancouver, BC, theorizes that dislocation causes addiction. Free markets force people to move where the work is and leave their connections behind.

Walter Scottinspired visitors of the Stride gallery in Calgary, Alberta, to think about the fragile links that tie oneself to the place where they are born. They are nourished over the lifetime, consciously or unconsciously. One may not realise how frail they are, until they become stretched to a point of breaking.
Finally, in the Letters to Grandchildren (Greystone Books, 2015), David Suzuki offers grandfatherly advice to his five grandchildren, including this story about the horrendous journey of his Japanese ancestors to Canada:

Four years post doctorate

Being a senior postdoc brings many opportunities. I wrote about them in my blog last year. Now, I’d like to revisit them, see what’s new and what has changed.
CREDIT: Hal Mayforth


 Three years post doctorate, I wanted:

-To keep writing a lot.
In the third year post doctorate, I wrote a lot about these topics:
 How doctors sweat to discover traditions of the first nations; What to look for in mentoring? Finding the Evidence for Talking Therapies; My First Week in the Addiction Research Paradise; How to go about getting a postdoc position?; How mentoring can help transitions in academia; The best time for writing; Postdoctoral Fellowship Awards for Irish researchers; How to addess a Training Gap through Addiction Research Education for Medical Students; Mobility is part of research job description;Different styles of research supervision; How attractive are you for postgraduate students? How to build research leaders and supervisors; Working and holidays; The Annual Symposium of the Society for the Study of Addiction 2013; Re-entry shock; Saying bye slowly makes parting easier; A decade in the addictions field.

-To stay true to myself.
This was difficult. At times, I honestly have not been honest. I’ll keep at it.

-To reach a position of independence by:

a) conducting a randomized controlled trial
The pilot trial is finished. First, we wrote down our plan, a cook book for making this trial. Second, we developed and pilot tested a workshop which was later used as part of the experimental intervention. The controls received the intervention with a delay. Third, we measured the status at baselineto set up our starting point. Watch this space for more about the trial results.

b) supervising work of junior investigators.
My junior colleagues from the pilot trial helped me to learn how to be a better team player.

-To pass the accumulated knowledge and skills on other:

c) Doctors and helping professions, by helping them become more competent and confident in addiction medicine research
d) Medical students, by helping them discover and master addiction medicine research.
I had the honour to co-supervise a group of three gifted postdocs and several medical students. Two of them moved for work or study to UK. I’m grateful for the learning that workingwith them brought me.

-To maintain a happy work-life balance.
At the time when I wrote that, I realised that I took on too much. In the past year, life and family brought new challenges and I needed to split my time between them. Integrating my scientist and artist careers was another chance to learn the balancing act.

In the fourth, post-doctoral year, I’ve extended my research to addiction medicine education. This is new to me. This expansion challenged my time management skills. I wish to be able to see which of my ideas and projects need more attention and which should be put to sleep.