EPIDEMIOLOGY OF THE PROVINCIAL OPIOID …...Education and Training • Addiction Nursing Fellowships...
Transcript of EPIDEMIOLOGY OF THE PROVINCIAL OPIOID …...Education and Training • Addiction Nursing Fellowships...
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Samantha Robinson, RN, MPH
Clinical Programs and Development Lead
Associate Director, Addiction Nursing Fellowship
Mobilizing All Nurses to Address
Substance Use:
Canadian Perspectives
Conflicts of Interest
• No conflicts to declare
Overview
• Epidemiology of the opioid epidemic in British
Columbia
• Overview of BCCSU
• Clinical guidelines for nurses
• Educational guidelines for entry-level nurses
• Top 3 challenges (‘opportunities’)
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EPIDEMIOLOGY OF THE
PROVINCIAL OPIOID EPIDEMIC
1013
500
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2010
2012
2014
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2016
OVERVIEW OF THE BC CENTER ON SUBSTANCE
USE
Core Functions
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Clinical Guidelines for Nurses
Injectable Opioid Agonist Treatment (iOAT) :
Hydromorphone
• SALOME (Ovideo-Jokes, E et al. JAMA
Psychiatry 2016)
• First in North America
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Overview of management options for OUD
Education for Nurses in the clinical
management of patients with substance use
disorders or problematic substance use
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Education and Training
• Online Addiction Medicine Diploma
– Free, online, broad overview of addiction medicine, 16
hours, CME accredited
– Topics covered:• Screening, Diagnosis, and Brief Intervention for SUD
• Opioid, Tobacco, and Alcohol Use Disorders
• Withdrawal Syndromes
• Stimulant Use Disorder
• Polysubstance Use
• Co-occurring Disorders
• Pain and Substance Use Disorders
• Safe Prescribing
• Harm Reduction and Overdose Prevention
• Psychosocial Interventions
• Addiction in the Workplace
• Recovery Oriented Systems of Care
Over 4300Participants enrolled in the Online Diploma
10% are physicians and 50% are nurses
416People have completed the course and have their Diploma
Education and Training
• Online Addiction Medicine Diploma
– Nursing modules in development
• Introduction to addictions
• Screening and care planning
• Specialized assessments
• Supervised injection practice
• Addiction outreach and case management
• Policy, legal and ethical issues
• Nursing vicarious trauma and self care
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Education and Training
• Addiction Nursing Fellowships
– 400 Clinical Practice Hours
– Core Rotations: St. Paul’s Addiction Medicine Consult Team, St. Paul’s Rapid Access Addiction Clinic, Inner City Youth, ACT Teams, Pain Management Orion Health, among others
– Electives
– Motivational interview training (sessions)
• Curriculum development
– International entry-level nursing competencies
– Find me if interested in chatting further!
Nursing Successes and Remaining
Challenges/Opportunities
NALOXONE FOR OD PREVENTION
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What it is:
-A place where people inject pre-
obtained drugs in a supervised setting
-Harm reduction supplies provided
-Staff equipped to treat overdoses
-Education on safer injecting practices
-Can connect people to treatment
What it is not:
-A place to purchase drugs
-A place where the government
supplies individuals with drugs
-A place where other people inject you
with drugs
SUPERVISED CONSUMPTION SITES
Including plans to increase scope to include prescribing for opioid agonist
treatments in early 2017 (buprenorphine/naloxone) and methadone down
the road
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Employ a Cascade of Care Approach for
Substance Use Disorders
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Advocate for services and supports for
those most impacted
Source: First Nations Health Authority, 2017
Canadian Nurse, 2002