Brought to you by the HFHT Choosing Wisely Committee...
Addiction Medicine
March 20, 2018
eConsult continues to grow in Hamilton, with more physicians signing up and the number of consultations increasing. There are advantages to using eConsult in all specialty areas but a very topical one is Addiction Medicine.

Dr. Lori Regenstreif is the Lead Physician at the Hamilton Clinic, an Ontario Addiction Treatment Centre and a Family Medicine/Addiction Medicine consultant. She was asked what kind of cases could be best dealt with by an eConsult. Her response:
  • Patients wishing to stop taking/using opioids but finding they are unable to. Often are embarrassed and their lives might be unravelling.  Can be varying degrees of severity.

  • Patients unable to reduce/control/stop drinking alcohol, wishing to either stop completely or drink in a “controlled” way (less than 3 drinks per day) using a medication.

  • Anyone who shows up ASKING for help with a substance is miles ahead of what we see acutely and an ideal time for intervention.

  • Possibly, people with chronic pain, on high doses of opioids >90MEQ/day who are not benefiting from the opioids and wish to get off them. The chronic pain clinicians could probably also help with this. But we sometimes get overlap.
Lori also shares that...

"Pretty well any time a family doctor feels they are 'over their head' with their opioid prescribing and want some guidance, we can probably help. Also, there is much interest in Suboxone. With suboxone, it is hoped (though not yet supported with enough data) that suboxone might be a safer alternative for patients with chronic pain. And yes, for people trying to get off all opioids, a switch to suboxone and a taper over a few weeks is also an option."
Plans are being made in to help people get signed on with OTN for eConsult, as well as tips and tricks for submitting a referral. If you would like more help in this area, contact us using the grey button below.

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