Addiction Practice Pod

Navigating abstinence-based perspectives in substance use care can be complex. Within Indigenous communities, these complexities also intersect with the impacts of colonialism. Abstinence-based perspectives may arise or align with Indigenous teachings, they may stem from imposed colonial values, or both may be true. It is important to recognize that there are a variety of explanations for why abstinence-based approaches may be promoted, and that these can offer a healing path for individuals when aligned with Indigenous worldviews. 

In this episode of the Addiction Practice Pod, award-winning journalist David P. Ball and First Nation Health Authority’s Medical Officer of Mental Health and Wellness, Dr. Nolan Hop Wo, discuss potential benefits and harms from abstinence-based approaches to substance use care. We also hear from Keshia Cleaver, Harm Reduction and Program Advisor with The Four Directions Team at First Nations Health Authority, on why abstinence-based perspectives are common in some Indigenous communities, and how to meet communities where they are at with harm reduction. 

You can find additional resources and clinical pearls from the episode in the show notes: bit.ly/APP-S4E2

Artwork by Brianna Bear

The ongoing impacts of colonization continue to affect the health and wellness of Indigenous Peoples, evident in the disproportionate rates of toxic drug poisonings and deaths experienced by Indigenous people as compared to non-Indigenous people. Addressing the harms related to substance use in these communities involves acknowledging and reducing the harms of colonialism, while emphasizing and building upon the strengths and resilience of Indigenous Peoples.

In this episode of the Addiction Practice Pod, award-winning journalist David P. Ball speaks with the Medical Officer of Mental Health and Wellness at First Nations Health Authority, Dr. Nolan Hop Wo, on how colonialism and substance use are related. We also hear from Lacey Jones, Program Director of QomQem Coastal Connections, on strengths-based approaches to reducing the harms associated with colonialism.

You can find additional resources and clinical pearls from the episode in the show notes: bit.ly/APP-S4E1

Artwork by Brianna Bear

Families, including chosen families, can be an extremely important source of support in a person’s substances use care journey, but are often overlooked in substance use care planning.

In this episode of the Addiction Practice Pod, co-hosts David Ball and Christina Chant discuss the complexities and strengths of involving families in substance use care. In a slight departure from usual programming, Christina is joined by her sister, Lauren Chant, to provide their unique perspectives as both clinicians and family members with years of experience navigating the health care system.

We'd love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep6

Prescribed safer supply aims to provide access to a legal and regulated supply of drugs, in order to reduce the risk of harms and death associated with using the increasingly toxic unregulated drug supply. In this episode of the Addiction Practice Pod, Dr. Marcus Greatheart and journalist David Ball discuss prescribed safer supply with guests who have on-the-ground experience.

First, we hear from harm reduction nurse educator Corey Ranger, on the concept of a “safer supply”, and steps clinicians can take to make prescribed safer supply programs more effective. Corey also shares some lessons learned from participants at the Victoria SAFER Initiative, a prescribed safer supply program in Victoria, BC. From Safer Opioid Supply (SOS) in London, Ontario, Dr. Andrea Sereda discusses the importance of listening to your client’s needs when it comes to their substance use, including what they need to reduce their reliance on the unregulated supply, and shares some preliminary data from SOS. We also hear from the co-founder of the Coalition of Substance Users of the North (CSUN), Jenny McDougall, on the importance of providing lower-barrier care options for individuals who are experiencing harms from the unregulated drug supply.

We'd love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep5

Through providing small doses of alcohol to clients regularly, managed alcohol programs reduce the risks associated with heavy drinking and non-beverage alcohol consumption without requiring abstinence.

In this episode of the Addiction Practice Pod, Dr. Marcus Greatheart and David Ball talk with public health researcher and executive director of the Vancouver Area Network of Drug Users, Brittany Graham, about the purpose of managed alcohol programs and how they fit into the continuum of care for alcohol use disorder. We also hear from harm reduction advocate and peer leader, George Sedore, about what led him to join a managed alcohol program and how this has impacted his life.

We'd love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep4

Urine drug testing (UDT) is an important part of providing care to individuals with substance use disorders, from confirming baseline substance use to evaluating treatment outcomes. However, many individuals have had negative experiences with UDT. When UDT procedures feel punitive, it can impact whether an individual will continue to access care.

In this episode of the Addiction Practice Pod, Dr. Marcus Greatheart and David Ball talk with family nurse practitioner Tracey Day about how to effectively communicate with a patient about UDT and build a care plan collaboratively. We also hear from peer navigator and clinical care advocate Reija Jean, on the impact of negative UDT experiences, and how care providers can build respectful and safe therapeutic relationships.

We'd love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep3

Individuals and communities in BC are facing an increased risk of stimulant-related harms. Stimulant use can cause significant harms on its own, including negative cardiac and mental health outcomes. In the context of the unregulated drug supply, toxic drug poisonings can occur due to contamination of stimulants with opioids and other substances.

In this episode of Addiction Practice Pod, Dr. Marcus Greatheart and David Ball talk with addiction psychiatrist Dr. Julius Elefante about harm reduction and treatment for stimulant use disorder. We also hear from the executive director of UNDU, Katt Cadieux, on the importance of trusting your patient and building a care plan based on their lived experience.

We'd love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep2

Alcohol withdrawal management is an important part of the continuum of care for alcohol use disorder. While some individuals at low risk of complications can safely undergo alcohol withdrawal at home, others may require inpatient withdrawal management services to prevent life-threatening complications.

In this episode of Addiction Practice Pod, Dr. Marcus Greatheart and David Ball talk with clinical nurse specialist Avee Khela about alcohol withdrawal management pathways, and we hear from Sandra Stewart on the importance of compassionate, non-judgemental care.

We’d love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep1

In Canada and around the world, colonial histories continue to influence people's access to determinants of good health. Our society continues to advantage White people, and addiction medicine is no exception.

In this episode, Dr. Robert Fox, David Ball, and their guests discuss the intersections of race, ethnicity, and substance use. How can we make our clinics more accessible for people of different racial and ethnic identities? How can we unlearn our own racial prejudice? In this episode, we use the term ‘racialized’ to indicate groups who are marginalized according to race as a part of their identity.

We’d love to hear your feedback after the show. Find our evaluation, along with our show notes here: https://bit.ly/3uJPAe2

Evidence-based treatments often focus on a specific type of substance, like opioids or stimulants. However, many people have more than one substance that they use frequently.

In this episode, Dr. Lindsay Mackay, David Ball and their guests talk about co-occurring substance use and its implications in clinical care. In particular, they discuss co-occurring substance use as it relates to gender and to stigma in the clinic.

We’d love to hear your feedback after the show. Find our evaluation, along with our show notes here: https://bit.ly/3LciDfR