Dr. Bayla Schecter, Addictions Specialist Helen Brown, RN Intake Nurse Louise Hill, MSW Addiction Outpatient Treatment (Quadra Clinic) Coordinator

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1 Dr. Bayla Schecter, Addictions Specialist Helen Brown, RN Intake Nurse Louise Hill, MSW Addiction Outpatient p Treatment (Quadra Clinic) Coordinator

2 VIHA Addiction Services Map (PH ) Does the person want to stop using at this time? Yes Can the person stop using on their own? Maybe No No Yes Addiction Intake Family Physicians FAX referrals here Open 8 AM to 9 PM 7 days/wk Clients must call to receive service Either Addiction Information Session Overview of addiction services in Victoria Location: 1250 Quadra Street Time: 1330 hrs, Tuesdays & Thursdays Sobering Centre Short term refuge For people under the influence Walk in facility, open 24 hours per day Community Medical Detox Provides medically supervised withdrawal management services Length of stay 3 to 10 days Recovery Outpatient Support Flexible, abstinence based day program For people new or returning to recovery Open 7 days a week Addiction Outpatient Treatment Provides addiction counselling In groups or individually Supportive recovery beds Pembroke Stabilization Early recovery from 7 to 30 days Lilac, Holly and The Grove For stays up to 3 months

3 Victoria Community Detox (Inpatient) 5A(21 beds) Goals of care to safely and comfortably withdraw clients from current use of alcohol and drugs. 24 hour medically supervised evaluation and withdrawal management. a voluntary program clients may leave at any time. Clients stay 3 10 days

4 Addictions Intake for Detox Referrals PATIENT INFORMATION MENTAL HEALTH & ADDICTIONS INTAKE REFERRAL FORM (FOR PATIENTS 19+) For persons best starting with Mental Health, fax to (250) For persons best starting with Addictions, fax to (250) PLEASE PRINT LEGIBLY Name: last first alias?: Gender: M F Other DOB (dd-mm-yyyy): - - PHN: 9 Address: MRN #: Phone # Home: Work/Other: REFERRAL INFORMATION Date of Referral: Source of Referral: Family Physician: Phone: Private Line: Fax: Date of last physical exam: Is patient supportive of this referral? Y N REASON FOR REFERRAL WHY IS THIS PATIENT SEEKING MENTAL HEALTH OR ADDICTION SERVICES? CURRENT CLINICAL FEATURES - Please check all that apply: Risk Factors: Pronounced and/or Resistant Depression Chronic Emotional/Behavioural Instability Risk of harm to others plan? means available Psychotic Symptoms Generalized Anxiety Risk of harm to self plan? Manic/Hypomanic Symptoms Panic Attacks means available Major Cognitive Impairment/Disorganization Social Phobia Suicide attempt history method Unstable/Lack of Housing Obsessive/Compulsive Behaviours Recent actions taken to a suicide/homicide plan (e.g. Other: Other: writing will, procuring means, giving away belongings) Significant Drug/Alcohol Abuse? (Please mark below) Substance Typical Method Quantity Frequency Behaviour influenced by delusions/hallucinations 1. Patient is experiencing command hallucinations 2. Pronounced Self Neglect Serious complicating medical problem? 3. Please describe any risk factors identified: 4. Previous/Current Treatments: (Including psychiatric admissions & addictions services) Dose Date Type Medical History and Investigations: (Please attach investigation results) * IF PATIENT S RISK REQUIRES A RESPONSE TODAY, PLEASE REFER TO 3. IMCRT (MOBILE CRISIS TEAM after 1300 hrs Confidential Pager for professionals only) OR TO THE EMERGENCY ROOM, OR CALL The client or advocate MUST call Addictions Intake Clinical notification of referral status sent after 30 days if not sooner PLEASE DESCRIBE CURRENT SYMPTOMS AND ANY COMPLICATING FACTORS: TO BE COMPLETED BY MHAS ADMINISTRATIVE STAFF: Systems Checked: CERNER MH Intake Tracking System PM Office MHDB Powerchart reviewed by clinician CURRENT MEDICATIONS: (Attach printout of current symptoms/medications from GP Chart if preferred) Type Dose When Initiated Any Adverse Drug Reactions? Any Problem Affording Medications? Any Allergies? TO BE COMPLETED BY INTAKE STAFF: Message Log: To Whom When M/L Staff Signature Please fax this form and the completed Patient Questionnaire to either: Mental Health Intake (250) or Addictions Intake (250) Physicians can consult with a Mental Health Intake worker by calling Physicians can consult with an Addictions Intake Worker by calling The referral will be processed once Intake has received the Patient Questionnaire and this form rev2

5 Addiction Intake Referral Form 1. Fax Intake Form (Client Questionnaire optional for detox patients) 2. Expectation is clients will call Addiction Intake 3. Refer to brochure for patients 4. Physicians can flag referrals as medically urgent 5. Intake staff are available for telephone consultations with referring physician. Intake staff may suggest an addiction physician provide advice di for family physician i

6 Detox admission process Each client is interviewed in person or on the phone by Intake Staff who send an electronic referral sent to the appropriate service Once interviewed detox clients are discussed in a dil daily triage with detox staff tff and physicians i Once client is accepted on to the detox waitlist and has a chest X ray within the last 6 months we ask them to call Addictions Intake daily for bed availability

7 Waiting for detox Pembroke Site Clients can be encouraged to use the time waiting for detox to look into getting post detox support. We do not encourage clients to stop using before entering detox but do encourage them to cut back. Wait times are variable from 2 days to 2 weeks.

8 Victoria Community Detox Chronic Pain And Opiate Use Victoria Detox will withdraw clients from opiates Will not initiate pain management. Will not initiate clients on methadone or suboxone maintenance

9 Benzodiazepine Withdrawal Clients encouraged to taper in the community under the guidance of their Family Physician Clients can be referred for a consultation with an addictions Physician at Adult Outpatient Therapy (AOT) Clients encouraged to access programs at AOT

10 Sobering and Assessment Centre Services (Pembroke Site) Open 24 hours a day 7 days a week No referrals needed For inebriated clients (must have used within the last 6 hours). Offers safe, warm shelter, physical risk assessment, laundry, showers and snacks Clients can stay up to 23 hours

11 Pembroke Stabilization ti Program Goal is for clients in early recovery to re establish themselves in a healthy lifestyle and continue to work on recovery goals Stay can be from 7 to 28 days. Referrals accepted only from Addiction counsellors Patient cost of $40 a day provides residential i stabilization and supportive recovery programs N t t th ii b fit th h No cost to those receiving benefits through Income Assistance

12 Recovery Addiction Support (Outpatient): A flexible, abstinence based day program for people new or returning to recovery Open 7 days a week with daily groups

13 Addiction Outpatient Treatment (AOT) Quadra Clinic First step to access AOT Information Session at 1250 Quadra St. Held every Tuesday and Thursday at 1:30 pm for clients and supportive others Drop ins accepted Advise to arrive 20 minutes early due to limited space

14 Notions about Treatment: something that is done to a client to fix them one event detox alone/getting ao g the substance misusing person to quit Addiction Treatment What it is: a collaborative process between the client and the counsellor where the client finds their own reasons for change where the client needs to take on going action, in ways that make sense to the client a supported process of self discovery and other learning, growth and healing a process detox may be a first step continued work includes the client finding ways/developing skills and knowledge to maintain their goals: abstinence/harm reduction for the long term

15 More myths on addictions only for people who are ready a time limited offer assistance to prepare/get ready for change o being pre contemplative that is, not seeing that t one has a problem, is a legitimate place to be in the process of change something people may have to attempt many times Okay to window shop and browse and hopefully return as a customer

16 Myths (cont d) a one size fits all a selection of services and modalities tailored to the client s assessed needs residential it may be outpatient services in one s own community or a combination

17 Addiction Outpatient ti ttreatment t(aot) 1:1 and group counselling: first and second stage treatment. Referral to residential treatment Referral to other MHAS services Psychiatric i consultation ti and follow up Consultation and follow up with an Addictions Physician Support for family members/ those affected by the substance use of someone else

18 Supportive Recovery er Program Residential houses: Holly Place 5 beds for women; Lilac Place 5 beds for women; The Grove 10 beds for men Group treatments available through Addictions Outpatient Treatment (Quadra Clinic) Coaching on basic life skills Development of individual treatment planning and linkage to appropriate it community support services

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