epidemiology of the provincial opioid …...education and training • addiction nursing fellowships...
TRANSCRIPT
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’)
EPIDEMIOLOGY OF THE
PROVINCIAL OPIOID EPIDEMIC
1013
500
2010
2012
2014
2016
OVERVIEW OF THE BC CENTER ON SUBSTANCE
USE
Core Functions
Clinical Guidelines for Nurses
Injectable Opioid Agonist Treatment (iOAT) :
Hydromorphone
• SALOME (Ovideo-Jokes, E et al. JAMA
Psychiatry 2016)
• First in North America
Overview of management options for OUD
Education for Nurses in the clinical
management of patients with substance use
disorders or problematic substance use
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
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
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
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
