Battling the opioid crisis: Walk-in service at The Royal provides harm-reduction, treatment options
New clinic offers services for people with opioid use disorders
Opioid use is one of the biggest health challenges facing communities today. Opioids such as fentanyl are easy to get, highly addictive, and potentially fatal. So when somebody who uses opioids is ready to get help, help needs to be there. That’s where The Royal’s opioid services come in.
“There is an opioid crisis in Canada, and it is having devastating consequences on our communities, on our patients, on our families,” said Dr. Kim Corace, director of clinical programming and research in the Substance Use and Concurrent Disorders Program at The Royal. “All of us who are health care workers have witnessed the devastating consequences, which can often include overdose and death.”
Last year alone nearly 4,000 people were victims of apparent opioid-related deaths in Canada, a 34 percent increase over 2016. Current estimates indicate the 2018 figures will be even higher. Opioid-related deaths increased 50 percent in Ontario alone in 2017, to an estimated 1,265.
The escalation in opioid use has been linked to over-prescribing of opioid-based painkillers, which were originally marketed as lowrisk and non-addictive. Since the early 2000s, opioids have become more potent and accessible, exacerbated by the development of illicitly manufactured fentanyl, a widely available and highly toxic synthetic narcotic.
The problem is widespread and it spans all social groups. “I think these days you’d be hard-pressed to find somebody who isn’t personally affected by the opioid crisis, either through themselves or through a family member or a friend,” said Corace.
The Royal has recently introduced walk-in services for individuals with opioid use disorders in addition to its already established Regional Opioid Intervention Service. The new Rapid Access Addiction Medicine Clinic for problems with opioid use offers harm reduction services, treatment options, and links to community services. It is staffed by a team of doctors, nurses, social workers, and an addiction counsellor. For walk in clinic times, people can call 613-7226521 ext. 6508.
When someone walks into the clinic for the first time, they can expect to meet with a member of the team to discuss their goals and how The Royal can help. Help may mean decreasing the harm associated with a person’s opioid use, managing withdrawal symptoms, or providing medication or counselling. Connecting people with the right community resources is also an important part of the service.
“You don’t have to come wanting to stop using opioids. You can come in just willing to have a discussion,” said Dr. Melanie Willows, clinical director of The Royal’s Substance Use and Concurrent Disorders Program. “We meet people where they are at. We work together to try to keep people safe, and help them get the most appropriate care either at The Royal or in the community.”
The opioid service is part of The Royal’s Substance Use and Concurrent Disorders Program, which includes a broad range of services to address mental and physical health problems associated with drug and alcohol use.
“Failure to treat both a person’s substance use and mental and physical health problems at the same time results in poor outcomes,” said Corace, adding that strong connections with community partners and training that supports primary-care providers are part of The Royal’s multi-faceted approach to treating substance use disorders.
The Ontario government has plans to roll out about 50 Rapid Access Addiction Medication clinics across the province. The rapid access model — which The Royal has implemented for alcohol use as well as opioid use — can help reduce wait times, visits to emergency departments, and hospitalizations.