New rapid medical addictions clinic 'imminent' for Windsor, says health network
Rapid Access Addiction Medicine clinics exist across Ontario, piloted in Sarnia
A new addictions clinic designed to help people quickly access medical treatment for opioid and alcohol addictions in Windsor is "imminent," according to the Erie St. Clair Local Health Integration Network (LHIN).
A Rapid Access Addiction Medicine (RAAM) clinic integrates opioid replacement therapy with primary care and provides assessment, counselling and prescriptions of appropriate medications.
Dr. Del Donald runs the Bluewater RAAM clinic in Sarnia, which opened as a pilot site in 2016. He said 50 sites have opened across the province since.
"It really is a great thing that's happened."
Donald said a Windsor clinic connected with him after the Sarnia site opened to learn from the Bluewater RAAM clinic.
What does it look like?
The Bluewater RAAM clinic is designed to look like a restaurant, said Donald, with an emphasis placed on comfort for patients who can walk in without an appointment to see a physician on their first visit.
"We talk about the medication, which one we're suggesting and what they can expect from it and things like that," he said, adding those medications are usually buprenorphine or methadone.
Patients are usually seen again in a week or less, depending on their addiction.
But a RAAM clinic doesn't need to be a specific physical space, according to the Erie-St.Clair LHIN.
"We need to look less at is it a bricks and mortar type of place or is it really a process so that people get access to those resources very, very quickly," said Shannon Sasseville, director of communications and community engagement at the Erie St. Clair LHIN.
Current system 'not well-organized'
Dr. Tony Hammer specializes in addictions treatment with Erie-St. Clair Clinic — the clinic that reached out to the Sarnia site — and he believes barriers have prevented a RAAM clinic from opening in Windsor-Essex.
He said addictions treatment is "not well-organized" between the community and hospitals to create a seamless process.
"At the moment the problem is that it's half-hospital based, half-community based — it should be community based," said Hammer.
"We need some kind of overriding authority here who can organize it."
Available by year end?
The Erie-St.Clair LHIN is the authority that plans, integrates and funds local health care over an area that includes both Sarnia, which has had a RAAM clinic since 2016, and Windsor-Essex.
"Sometimes change just takes longer than we probably think it does," said Sasseville.
However, she said a Windsor RAAM clinic is "imminent," but the process of getting partners on board takes time.
"We're at, really, the final stages of making sure if patients want to visit a RAAM clinic that all the partners are ready and available for them."
Sarnia's RAAM clinic, by the numbers
Donald, who runs the RAAM clinic in Sarnia, has noticed the following in the first two years:
- 317 patients seen since March 2016.
- 130 patients continue to use the clinic.
- Patient visits to emergency department reduced by roughly 50 per cent.
The clinic is available for 36 hours a week.
"It's an option for those services or physicians to offer something to the patients they didn't have before," said Donald.
What's available now
Dr. Hammer said there are two types of services available in Windsor: abstinence-based treatment and medical-based treatment.
"What we know is that if we can get these patients onto medical treatment, which is suboxone and methadone, we can reduce the death rate from accidental overdose by 75 per cent," said Hammer.
Not only that, he believes that abstinence-based withdrawal is dangerous.
Here's part of <a href="https://twitter.com/KafferJkaffer?ref_src=twsrc%5Etfw">@KafferJkaffer</a>'s chat with <a href="https://twitter.com/JasonViauCBC?ref_src=twsrc%5Etfw">@JasonViauCBC</a> on <a href="https://twitter.com/CBCWindsor?ref_src=twsrc%5Etfw">@CBCWindsor</a> about overdoses in Windsor. <br><br>"I think we haven't really fully agreed in our community what the problem is, number one," said Kaffer. <br><br>"We really still have some disagreement on the way forward." <a href="https://t.co/wbId8jvSpm">pic.twitter.com/wbId8jvSpm</a>
—@ChrisEnsingCBC
Donald also believes medical addictions treatment is best for patients.
"A traditional sort of detox, I guess we call it withdrawal management now, isn't very helpful. It certainly does nothing for opioid-use disorder because what they really need is to be put on opioid replacement therapy," said Donald.