PI: David Hodgins (University of Calgary, AB)

Leadership Group: Brian Rush (CAMH, ON), Lynette Katsivo (Addictions and Mental Health Ontario, ON); Gail Czukar (ON); Cam Wild (University of Alberta, AB); Lena Quilty (CAMH, ON); Lois Jackson (Dalhousie University, NS); Simon Debreucq (CHUM, QC); Carson McPherson (British Columbia Centre on Substance Use)

Background

There are “two worlds” of treatment services for opioid use disorder: specialized addiction treatment and recovery services that provide a variety of psychosocial interventions across a range of settings (outpatient, day programs, residential programs) and opioid antagonist treatments (OAT) that provide methadone and/or buprenorphine in medical services.  Individuals in some communities can access either or both of these options, whereas many other communities have limited access to OAT. Until recently, these two worlds operated largely independently, but the opioid crisis has both increased recognition of the gap between these models and has facilitated a shift toward integration in some areas of the country. However, at present we do not have a fulsome, comprehensive understanding of the current status of the treatment of opioid use disorder within the psychosocial treatment system.

Objectives

  • Developing a comprehensive understanding of how opioid use disorder is treated currently in psychosocial addiction treatment and recovery programs across Canada;
  • Identifying types of outcomes (if any) routinely collected to document effectiveness of the treatment of individuals with opioid use disorder in psychosocial treatment and recovery programs;
  • Describing attitudes and philosophical beliefs of psychosocial treatment providers towards OAT and other harm reduction interventions;
  • Describing the current use of OAT within these programs as well as support for clients wishing to use OAT concurrently with their involvement in psychosocial programs;
  • Describing perceived program-level and individual-level barriers towards integrated OAT-psychosocial treatment;
  • Identifying current gaps or perceived needs in psychosocial treatment and recovery programs for opioid use disorder;
  • Identifying best practice model program descriptions; and
  • Developing of an implementation plan to increase uptake of best practice and evaluate its impact

Project Components

TREATMENT SURVEY

CRISM has completed a survey on the range of current approaches to the treatment of individuals with opioid use disorder within psychosocial addiction treatment programs across Canada (n=202)

SCOPING REVIEW

Psychosocial interventions to treat OUD. Review has been completed and main paper has been published. Other sub-studies of this dataset are underway including analysis of qualitative studies.

CASE STUDIES

The completed survey results and input from stakeholders are being used to develop case studies of model programs across Canada. This information will provide the basis for developing a practice support resource and an intervention plan for improving the treatment of individuals with dependence, based upon services gaps, attitudes, barriers, and the perceived needs of programs.