Category: Evidence based treatment

Hospital based opioid agonist treatment

Researchers in Canada have found a significant number of individuals with co-occurring mental health and substance use disorders are admitted to inpatient psychiatric units. We looked at those admitted to an acute care hospital in Vancouver, British Columbia, whom had been referred to an addiction medicine consult team, to develop a greater understanding of this population and of the care being provided in order to improve care outcomes and patients’ care experiences. (more…)

Pain Management with Opioids in 2019-2020

This JAMA Insights Clinical Update reviews evidence-based use of opioids to manage noncancer pain, proposing opioid-sparing pain management.  Based on recent literature and the rapidly evolving nature of the opioid overdose epidemic due to the emergence of fentanyl analogues in the illicit drug supply, there are clearly 3 main clinical scenarios being confronted by clinicians where evidence-based recommendations can be made. (more…)

Boost for Oral Opioid Agonist Therapy

Although opioid agonist treatment is effective in treating opioid use disorders, retention in such treatment is suboptimal in part due to quality of care issues. A new initiative sought to boost treatment of opioid use disorders so that people stay there longer. This article describes how teams did in a structured quality improvement initiative in Vancouver, Canada. (more…)

Hospital teaching team keeps fighting opioid crisis

Overdose grafitti

Which student learns best with hospital teams fighting opioid crisis? Understanding how students learn is perhaps the most important way to improve addiction training.

In a new article published by the Substance Abuse journal,  we report findings suggesting that the completion of an elective with a hospital-based Addiction Medicine Consult Team appeared to improve knowledge of medical students more than of other types of students. Read more below or listen to the podcast.

Firstly, we found that both emerging and established physicians appear to be responsive to this type of training.  Secondly, the learner self-assessment can provide valuable feedback to the consultants. Then, consultants can focus more on the students who learn less.

Keep fighting opioid crisis through training

The study sample was drawn from medical students, residents and physicians who took part in a month-long rotation with a hospital-based addiction medicine consult team in Vancouver, Canada. The addiction rotation includes full-time clinical training involving intake assessment and treatment planning. And referrals to community agencies and starting people on evidence-based medications for substance use disorders. The students take part in didactic lectures, bedside teaching, journal clubs and some prepare papers for submission to peer-reviewed journals. Each year, about 80 learners go through the program. Furthermore, learners rate their knowledge before and after the training.

At the end, all learners reported increased knowledge. One group, however, learned more than the others – the medical students. This two-year study confirms that a structured clinical training program can lead to an increased knowledge on addiction and that medical students benefit from it the most.

For more info read the full article at:

Gorfinkel, L., Klimas, J., Ahamad, K., Mead, A., McLean, M., Fairgrieve, C., Nolan, S., Small, W., Cullen, W., Wood, E., Fairbairn, N. (2019) In-hospital training in addiction medicine:  A mixed methods study of health care provider benefits and differences. Substance Abuse (Published online Jan 28) doi: 10.1080/08897077.2018.1561596

If interested, you can also read: What can hospital teams teach medical students about addiction to help curb the opioid overdose epidemic?

Hospital teaching teams confront iatrogenic opioid addiction

 

Or visit a post that talks about this research as it was presented at the Canadian Society for Addiction Medicine link here

Canadian Society of Addiction Medicine, CSAM conference