Conference Program

Pre-Conference
November 3
November 4
November 5
Fundamentals
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November 3, 2022

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Registration
8:00 a.m. – to 6:30 p.m.

Foyer

Exhibition Table Tops
8:30 a.m. – to 6:30 p.m.

Foyer

 Exhibitor tables will be staffed during meals and breaks.

Track 1
Track 2
Track 3
Industry Track

8:30 a.m. – 9:00 a.m.

Adam Ballroom
WELCOME

Welcome & Conference Opening

9:00 a.m. – 10:00 a.m.

Adam Ballroom
Keynote
Bridging National Policies and Local Realities: Can we Coordinate for the Future?
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10:00 a.m. – 10:30 a.m.

Break

10:30 a.m. – 12:00 p.m.

Track 1

Terrace Lounge

Symposium

Partnering with Indigenous Elders to Help Indigenous People Living With Opioid Use Disorder

Learn More »
Track 2

Kelsey/Saskatchewan Room

Brief Presentations

What’s Next: The Future of Addiction Medicine in Canada

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Track 3

William Pascoe Room

Workshop

Working with Youth who Use Substances

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12:00 p.m. – 1:00 p.m.

Lunch

Battleford Room

Industry Session

The Path to Recovery: Where Are We Now? (Unaccredited Session)

12:30 p.m. – 2:00 p.m.

Poster Presentations

Learn More »

2:00 p.m. – 3:15 p.m.

Track 1

Terrace Lounge

special Lecture

Birds of a Feather Flock Together: Concurrent Substance Use Disorders and Personality Disorders

Learn More »
Oral Presentation

Comorbid Adult ADHD and Substance Use Disorders: Clinical Approaches

Learn More »
Track 2

William Pascoe Room

Brief Presentations
OAT Series 1: New Research and Best Practice
Learn More »

Kelsey/Saskatchewan Room

Featured Event
Recognizing and Responding to Intimate Partner Violence in Clinical Encounters

Additional Registration Required

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2:00 p.m. – 5:00 p.m.

Kelsey/Saskatchewan Room

Track 3
Featured Event
Recognizing and Responding to Intimate Partner Violence in Clinical Encounters

Additional Registration Required

Learn More »

3:15 p.m. – 3:30 p.m.

Break

3:30 p.m. – 4:45 p.m.

Track 1

Terrace Lounge

special Lecture

A History of Psychadelic Research in Canada

Learn More »
Track 2

William Pascoe Room

Brief Presentations

OAT Series 2: New Ideas and Thought Leadership

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4:45 p.m. – 5:00 p.m.

Break

5:00 p.m. – 6:30 p.m.

Track 1
Track 2

William Pascoe Room

Trainee Session

Stories of Lived Experience: a Trainee-Guided Discussion

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Track 3

Terrace Lounge

Brief Presentations

Psychedelics in the Treatment of Addiction: A Panel Discussion of the Good, the Bad and the Unknown

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7:00 p.m. – 9:00 p.m.

Foyer

WELCOME
Welcome Reception
Join us for good company and hearty hors d’oeuvres in the grand foyer of the Châteauesque-style Bessborough hotel, one of Canada’s grand railway hotels. All registered attendees are welcome!
Keynote

Bridging National Policies and Local Realities: Can we Coordinate for the Future?

In a high-level examination of Canada’s current position on substance use and addiction, distinguished policy expert Rebecca Jesseman will explore how national structure and policy trends intersect with local realities. She will synthesize the national context, touching on system structure related to mental health and substance use, emerging trends in policy and regulation, patterns of use and service delivery challenges. She will also look to the future, as the rapid changes triggered by the COVID-19 pandemic make the status quo increasingly untenable.

Rebecca Jesseman

Rebecca Jesseman

Health PEI

In a high-level examination of Canada’s current position on substance use and addiction, distinguished policy expert Rebecca Jesseman will explore how national structure and policy trends intersect with local realities. She will synthesize the national context, touching on system structure related to mental health and substance use, emerging trends in policy and regulation, patterns of use and service delivery challenges. She will also look to the future, as the rapid changes triggered by the COVID-19 pandemic make the status quo increasingly untenable.

Symposium

Partnering with Indigenous Elders to Help Indigenous People Living With Opioid Use Disorder

This symposium will focus on the health of Indigenous peoples living with opioid use disorder (OUD). It will present findings from a Health Canada-funded expansion project at Kilala Lelum Urban Indigenous Health and Healing Cooperative in Vancouver, an inner-city health centre that uses a partnership model of care with Indigenous Elders. These models have shown promise in a wide variety of clinical areas, particularly in mental health, and represent an important innovation to build a more equitable health system.

Exploring Staff and Provider Experiences

David Tu, MD
Leah Walker, Executive Director at Kilala Lelum

The model of service at Kilala Lelum has evolved from a Patient-Centred Medical Home model of care into what can be described as a PCMH+ model. In this innovative model, the “plus” represents the partnering of Indigenous Elders and Indigenous Medicine with mainstream primary care providers, and the inclusion of Indigenous people and Elders in leadership and decision-making roles. To better understand this model, qualitative interviews were conducted with staff across several role groups, resulting in the identification of five major themes. This presentation will provide an overview of the PCMH+ model of care and explore each of the major themes in detail.

Program Evaluation of a Non-Pharmacological Chronic Pain Management Program for People Living with Opioid Use Disorder and Chronic Pain: Implementation Experiences and Early Outcomes at the Kilala Lelum Health Centre

David Tu, MD
Jill Fikowski, MPH, Research Coordinator, Kilala Lelum

The model of service at Kilala Lelum has evolved from a Patient-Centred Medical Home model of care into what can be described as a PCMH+ model. In this innovative model, the “plus” represents the partnering of Indigenous Elders and Indigenous Medicine with mainstream primary care providers, and the inclusion of Indigenous people and Elders in leadership and decision-making roles. To better understand this model, qualitative interviews were conducted with staff across several role groups, resulting in the identification of five major themes. This presentation will provide an overview of the PCMH+ model of care and explore each of the major themes in detail.

Gathering Stories in a Prospective Cohort Study

David Tu, MD
Leah Walker, Executive Director at Kilala Lelum

The goal of this study was to gather stories and experiences that explore the impact that encounters with Indigenous Elders have on Indigenous people living with opioid use disorder in an inner-city, primary care setting. Study conclusions will be shared and summarized.
Brief Presentations

What’s Next: The Future of Addiction Medicine in Canada

What's Next for Care Delivery in Manitoba: Expanding on a Pilot of ECHO for Mental Health and Addiction

Krystal Thorington, MD, FRCPC, Child & Adolescent Psychiatrist, Lecturer, University of Manitoba
Erin Knight, MD, CCFP(AM), cISAM, Educational Director, Addiction Medicine Enhanced Skills Residency Program; Medical Director, FARHA Addiction Program; Medical Co-Lead, RAAM Hub, University of Manitoba; Four Arrows Regional Health Authority; Shared Health Manitoba
Jennifer Hensel, MD, FRCPC, MSc, Associate Professor, Department of Psychiatry, University of Manitoba
Ginette Poulin, MD, CCFP(AM), cISAM, Medical Co-Lead, Rapid Access to Addiction Medicine (RAAM) Hub, Shared Health Manitoba

Extension for Community Healthcare Outcomes (ECHO) is a well-established model that uses a virtual platform to connect an expert “hub” with primary care providers across broad distances. The goal of the ECHO program is to expand the capacity of primary care providers to treat the complex medical and mental health concerns of people in their community.

This presentation will summarize the work of four experienced Manitoba physicians who are piloting the ECHO program in their home province. They will discuss how other organizations may consider development, rollout, and continuous quality improvement of this useful model to support client care and education of health care providers who often report reluctance to treat substance use disorders due to lack of perceived knowledge or capacity.

Brain Ghrelin: A New Target for Anti-Addiction Medications?

Eliot L. Gardner, PhD, Chief, Neuropsychopharmacology Section, U.S. National Institute on Drug Abuse

A team of U.S. researchers has discovered that rats use less oxycodone when their ghrelin receptors are blocked, suggesting that interventions targeting the ghrelin system may be a viable treatment approach for opioid use disorders. Until recently, ghrelin was best known as the “hunger hormone,” but it has lately been found to play a role in the brain’s reward, craving and relapse circuitry.

Utilizing Machine Learning and Predictive Modeling for the Real-Time Identification of Patients Most Likely to Leave Substance Use Disorder Inpatient Treatment Against Medical Advice

John W. Shepard, CEO, Shepard Health

Learn how new technology can help caregivers predict with 91% accuracy which patients will leave a substance use treatment facility against medical advice. John W. Shepard, CEO of Shepard Health, analyzed 8,000 patient records from a 60-bed treatment facility in California and was able to identify the risk factors associated with early departure from treatment. The findings have important implications for treatment interventions and can help facilities reduce the cost of turnover to maintain profitable, sustainable operations.

Shaping Future Addiction and Mental Health Treatment Delivery by Integrating Clinician, Physician, and Patient Perspectives on In-Person and Telehealth Care

Shannon Jones, PhD, Clinical Psychologist, Alberta Health Services, University of Calgary
Emily Bedford, BSc, Clinical Psychometrist, Alberta Health Services
Kristina Brache, PhD, Clinical Psychologist, Alberta Health Services, University of Calgary
Dana Watts, B.A.(Hons), Research Coordinator and Student, University of Calgary

Hear the results of a unique study that gathered perspectives from clinicians and adult patients who provided or received virtual addiction and mental health services at a concurrent disorders clinic during the pandemic.

Workshop

Working with Youth Who Use Substances

Selene Etches, MD, FRCPC, Psychiatrist, Dalhousie University
Martha Ignaszewski, MD, FRCPC, Psychiatrist, BC Children and Women’s Hospital
Tea Rosic, MD, FRCPC, Psychiatrist, CHEO

In any given year, only 10% of adolescents who use substances receive any form of mental health or addiction treatment. The aim of this workshop is to provide an overview of youth substance use disorders, discuss validated screening measures, and explore strength-based treatment options for addictions and concurrent disorders.

Using case-based examples, elements of a comprehensive adolescent substance use disorder treatment program will be explored, as recently reviewed in a cross-Canada qualitative study of adolescent addiction programs (in press). These will include caregiver interventions, motivational interviewing with youth, working with youth engaged in sexual exploitation and exposed to intimate partner violence, medications to treat substance use disorders in adolescence, and using technology to improve youth engagement. A secondary component of the workshop will be to link together clinicians practicing in this field and explore their interest in a CSAM-SMCA sponsored special interest study group focused on this population.

Poster Presentations

Evidence-Informed Approaches for Supporting Family Caregivers of Persons with SUD

Angie Hamilton, LL.B, B.C.L., Executive Director, Families for Addiction Recovery (FAR)
Louise Lemieux White, RN, Co-Founder, Families for Addiction Recovery (FAR)

HIV Hospice and Transitional Care Home: A Realist Evaluation

Anum Ali, MBBS, Research Assistant, University of Saskatchewan
Melissa April, Patient Partner, Patient Partner, University of Saskatchewan
Tracey Carr, PhD, Research Associate, University of Saskatchewan
Maura MacPhee, RN, PhD, Professor, University of British Columbia
Gary Groot, MD, PhD, Professor, University of Saskatchewan

A Systematic Review of Prevalence of Comorbid Obsessive-Compulsive Disorder and Substance Use Disorder in Clinical Settings, 1990-2021

Babangida Tiyatiye, MD, MBSS, MPH, MHM, FRANZCP, Certified Addiction Psychiatrist, The Perth Clinic
Wole Akosile, MD, MBSS, MPH (UQ), FRANZCP, Certified Addiction Psychiatrist, FACHAM, PhD (QUT), New Farm Clinic

Use of Modern Screening and Contact Methods in OAT Clinics to Increase HCV Screening and Linkage to Care

Brittany Domm, RPN, Hepatitis C Case Manager, CATC
Kate Johnston, Director of Clinical Services, CATC

Engaging Immigrant Communities in Regina, Saskatchewan on Substance Use Discourses

Denis Owiti, RN, Student, University of Saskatchewan
Geoffrey Maina, RN, MSN, PhD, Professor, University of Saskatchewan, Prince Albert Campus
Razawa Maroof, MD, Regina Community Clinic

The Development and Evaluation of a Provider-Focused Educational Intervention About Alcohol Use Disorder in Patients with Cirrhosis

Emily Johnson, MSc, Graduate Student, University of Alberta
Sumantra Ghosh, MD, Physician, Alberta Health Services
Denise Campbell-Scherer, MD, Physician, University of Alberta
Gerald S Winder, MD, Physician, University of Michigan
Jessica Kirkwood, MD, Physician, University of Alberta
Puneeta Tandon, MD, MSc (Epi), Physician, University of Alberta

Effects of Buprenorphine/Naloxone and Methadone on Depressive Symptoms in People with Prescription Opioid Use Disorder: A Pragmatic Randomized Controlled Trial

Gabriel Bastien, BSc, PhD Student, CRCHUM
Christina McAnulty, MSc, PhD Student, CRCHUM
Omar Ledjiar, MSc, Statistician, URCA
Ahmed Hassan, MD, Centre for Addiction and Mental Health
Stéphanie Marsan, MD, CHUM
Annie Talbot, MD, CHUM
Eugenia Socias, MD, MSc, British Columbia Centre on Substance Use
Bernard Le Foll, MD, MSc, Centre for Addiction and Mental Health
Ron Lim, MD, University of Calgary
Didier Jutras-Aswad, MD, MSc, Doctor, CHUM

Screening Patterns of Individuals Reporting High-Risk Substance Use Within a Concurrent Disorders Program

George V. Kachkovski, BA Hons, BSN, Medical Student, McMaster University
Liah Rahman, BA Hons., Research Assistant and Project Coordinator, Peter Boris Center for Addictions Research
Emily Levitt, BA, PhD Student, Department of Psychiatry and Behavioral Neurosciences, McMaster University
Michael Amlung, PhD, Associate Professor, Department of Applied Behavioral Science, University of Kansas
Holly Raymond, MSW, Clinical Director, St. Joseph’s Healthcare
James MacKillop, PhD, Professor, Department of Psychiatry and Behavioural Neurosciences McMaster University and St. Joseph’s Healthcare Hamilton

A Case Series: Role of Depot Buprenorphine Injections (Sublocade) in Tapering from Sublingual Buprenorphine

Hussain Aboud, MD, CCFP(AM), Physician, Alberta Health Services

Understanding the Potential Impact of the COVID-19 Pandemic on Individuals with Substance Use Disorders

Emily Britton, MA, Research and Evaluation Associate, Homewood Research Institute
Radia Taisir, MSc, Data Analyst, Homewood Research Institute
Shannon Remers, MSc, Sr. Manager, Research and Outcomes, Homewood Health, Inc.
Yelena Chorny, MD, Chief of Addiction and Trauma Services, Homewood Health Centre
James MacKillop, PhD, Director, Peter Boris Centre for Addictions Research
Jean Costello, PhD, Director of Evaluation, Homewood Research Institute

Medication for Addiction Treatment and Electronic Referrals (MATTERS): Efficiently Linking Substance Use Disorder and Mental Health Patients to Care

Joshua Lynch, DO, FACEP, Associate Professor of Emergency and Addiction Medicine, University at Buffalo

Development, Implementation, and Evaluation of a Pharmacist-Led Interprofessional Chronic Pain Clinic

Katelyn Halpape, BSP, ACPR, PharmD, BCPP, Assistant Professor, University of Saskatchewan
Derek Jorgenson, BSP, PharmD, FCSHP, Professor of Pharmacy, University of Saskatchewan

The Association Between Socioeconomic Status and Survival After Opioid-Related Hospitalization: A Population-Based Study

Wasem Alsabbagh, BscPharm, PhD, Assistant Professor, School of Pharmacy, University of Waterloo
Mike Beazely, PhD, Associate Professor, School of Pharmacy, University of Waterloo
Noor-Ul-Huda Shah, MSc, Research assistant, School of Pharmacy, University of Waterloo
Feng Chang, PharmD, Associate Professor, School of Pharmacy, University of Waterloo
Martin Cooke, PhD, Associate Professor, School of Pharmacy, University of Waterloo
Susan Elliott, PhD, Professor, School of Pharmacy, University of Waterloo

Long-Term Treatment with BUP-XR in Patients Struggling to Abstain from Opioids

Daniel Rutrick, MD, Medical Director, Adams Clinical
Brent Boyett, DMD, DO, Chief Medical Officer, Bradford Health
Howard Hassman, DO, Chief Scientific Officer, Hassman Research Institute
Susan Learned, MD, PharmD, PhD, SVP, Indivior Inc.
Yue Zhao, PhD, Director, Biostatistics, Indivior Inc.

Transition of Patients Established on Long-Term Transmucosal Buprenorphine Treatment to Monthly Buprenorphine Injection

Frank Gray, MBChB, SVP, GMD, Indivior Inc.
Bret Ryder, B Pharm, MPH, Medical Director, Indivior Inc.
Celine M. Laffont, PhD, Director, Quantitative PK, Modeling and Simulation, Indivior Inc.

Modeling Buprenorphine Mitigation of Fentanyl-Induced Respiratory Depression

Celine M. Laffont, PhD, Director, Quantitative PK, Modeling and Simulation, Indivior Inc.
Erik Olofsen, PhD, Leiden University Medical Center
M Hyke Algera, PhD, Leiden University Medical Center
Laurence Moss, MD, PhD, Leiden University Medical Center
Robert Dobbins, MD, MDL, Drug Discovery & Translational Medicine, Indivior Inc.
Geert Jan Groeneveld, MD, PhD, Neurologist, Clinical Pharmacologist, Professor of Clinical Neuropharmacology, Leiden University Medical Center
Monique van Velzen, PhD, PhD, Leiden University Medical Center
Marieke Niesters, MD, Leiden University Medical Center
Albert Dahan, MD, PhD, Leiden University Medical Center

A First Look Into Homewood Health’s New Traumatic Stress Injury and Concurrent Program Outcomes

Shannon Remers, MSc, Senior Manager, Research and Outcomes, Homewood Health Inc.
Robert Waterman, PhD, Research Associate, Homewood Health Inc.
Emily Rossi, BSc, Research Assistant, Homewood Health Inc.

Homewood Health’s Approach to Opioid Treatment and the Use of Measurement-Based Care: A Success Story

Shannon Remers, MSc, Senior Manager, Research and Outcomes, Homewood Health Inc.
Robert Waterman, PhD, Research Associate, Homewood Health Inc.
Emily Rossi, BSc, Research Assistant, Homewood Health Inc.

Investigating the Impact of an Opioid Substitute Treatment Clinic in a Small, Rural Community in Newfoundland and Labrador

Josh Conway, BSc (Hons), Medical Student, Memorial University of Newfoundland
Jill Allison, PhD, Clinical Assistant Professor, Memorial University of Newfoundland

Special Lecture

Birds of a Feather Flock Together: Concurrent Substance Use Disorders and Personality Disorders

Ronald Fraser, Associate Professor, McGill University

Personality disorders (PDs) and substance use disorders (SUDs) are intimately linked, sharing many clinical features and frequently co-occurring. The presence of one disorder has a significant and negative impact on the prognosis of the other disorder, and individuals with concurrent disorders typically have greater severity of symptoms, are more resistant to treatment, and have an increased risk of relapse.

Despite the significant prevalence of concurrent PDs and SUDs, there is a scarcity of evidence-based treatment approaches for this population. Ideally, these individuals would be offered highly structured integrative care and evidence-based relapse prevention pharmacotherapy for addictive disorders, as there is very limited effective pharmacotherapy for personality disorders. This presentation explores the interface between SUDs and PDs, attempting to highlight the complex interaction of the respective disorders and how this might inform treatment choices, specifically the need for comprehensive approaches for patients suffering from PDs and addiction, a population who tend to be stigmatized and marginalized.

Oral Presentation

Comorbid Adult ADHD and Substance Use Disorders: Clinical Approaches

David Crockford, MD, FRCPC, DABPN, CCSAM, FCPA, DFAPA, Clinical Professor, University of Calgary
Anees Bahji, BSc(H), MD, CISAM, CCSAM, DABPN, FRCPC, Clinical Assistant, University of Calgary

Untreated attention deficit hyperactivity disorder (ADHD) in persons with substance use disorder leads to worse overall treatment outcomes, so identifying and correctly diagnosing ADHD is important. Once the diagnosis is clear, one of the most controversial questions in our field has been whether or not to prescribe a stimulant medication. In this session, Drs. Crockford and Bahji will explore screening practices, review the pros and cons of long-acting stimulants versus non-stimulants, and discuss a cautious approach to prescribing that balances objective measures of symptom control with monitoring for relapse or cravings for substance use.

Brief Presentations

OAT Series 1: New Research and Best Practice

This session includes six presentations looking at new research and best practices with opioid agonist therapy.

Craving Mediation of the Effect of Buprenorphine/Naloxone and Methadone on Opioid Use: Exploratory Results from a Randomized Controlled Trial

Christina McAnulty, PhD student, Université de Montréal
Gabriel Bastien, PhD student, Université de Montréal
M. Eugenia Socías, MD, MSc, Research Scientist, University of British Columbia
Ron Lim, Clinical Associate Professor, University of Calgary
Bernard Le Foll, Clinical Scientist, University of Toronto
Omar Ledjiar, Biostatistician, Centre Hospitalier Ste-Justine
Didier Jutras-Aswad, Research Scientist, Centre Hospitalier de l’Université de Montréal

Researchers sought to determine the degree to which craving mediates opioid use during opioid agonist therapy.

Ibogaine HCL for Acute Opioid Detoxification

Dr. Alberto Sola, MD, Lead Physician at Clear Sky Recovery, Universal Ibogaine

Dr. Alberto Sola will report on data from 197 individuals from Canada and the United States with opioid use disorder who underwent medically supervised ibogaine treatment at his clinic in Cancun, Mexico. The results of this retrospective observational study are expected to inform the design of ibogaine clinical trials here in Canada.

Probuphine in Practice

Irman Ghauri, MD, CCFP, AM, Addiction Physician, Virtual Opioid Dependency Program
Stryder Zobell, MD, CCFP, MBA, Addiction Physician, Virtual Opioid Dependency Program
Nathaniel Day, MD, CCFP, ABAM, FASAM, CHE

Physicians from Alberta’s Virtual Opioid Dependency Program have been providing patients with buprenorphine subdermal implants for over 18 months. In this session they will present an analysis of a cross section of patients who have been treated with Probuphine, reviewing outcomes and varied scenarios in order to support use of Probuphine as a more widespread tool in treating OUD.

A New Framework for Methadone Carries: Taking a Person-Centred, Evidence-Informed Approach

Jennifer Wyman, MD, FCFP, DABAM,MPH, Medical Educator, META:PHI (Mentoring, Education and Clinical Tools for Addiction: Partners in Health Integration)
Vincent Lam, MD, CCFP, Medical Director, Coderix Medical Clinic
Maria Zhang, RPh, BScPharmD, MSc, Advanced Practice Clinical Leader/Clinician Educator, Centre for Addiction and Mental Health
Andrew McLeod, Community Advisor, META:PHI
Charlotte Munro, Community Advisor, META:PHI
Suzanne Latreille, Community Advisor, META:PHI

A META:PHI working group has created a new framework for decision making regarding take-home dosing that reflects current literature, lived expertise and principles of patient-centred care. This session will be useful for those looking for evidence to inform dialogue and decision making about take-home doses in the current environment.

Transitioning from Methadone to Sublocade: Case Series Presentation

J Stryder ZoBell, BMSc, MD, MBA, CCFP, Physician | Virtual Opioid Dependency Program with Alberta Health Services
Imran Ghauri, MD, MRCGP, CCFP, AM, Physician | Virtual Opioid Dependency Program with Alberta Health Services

Alberta’s Virtual Opioid Dependency Program has 202 active clients receiving Sublocade injections. In this summary, physicians will present 13 cases of patients who were struggling with stability while dosing Methadone, who were not willing to transition to oral Suboxone, but were successfully transitioned to Sublocade.

Associations of Maximum Buprenorphine/Naloxone and Methadone Doses with Opioid Use, Retention in Treatment, and Adverse Events in Adults with Prescription Opioid Use Disorder: Exploratory Analyses from a Randomized Controlled Trial

Hamzah Bakouni, MSc, PhD, Stagiaire Post-doctoral, Montreal University
Christina McAnulty, MSc, PhD(c), Doctoral candidate, Montreal University
Ovidiu Tatar, MD, MSc, PhD(c), Doctoral candidate, Montreal University
Didier Jutras-Aswad, MD, MSc, Professor, Montreal University
Eugenia Socias, MD, Professor, University of British Columbia
Bernard Le Foll, MD, PhD, Professor, University of Toronto
Ron Lim, MD, Professor, University of Toronto
Keith Ahamad, MD, Professor, University of British Columbia

Researchers explored whether higher BUP-NX and methadone doses are associated with opioid-positive urine drug screenings, retention in treatment, and adverse events. They concluded that increasing methadone doses was associated with higher retention and may be related to its full opioid agonism. The absence of BUP-NX and methadone dose association with opioid-positive urine drug screenings and adverse events might underlie remaining confounders. Determining optimal OAT titration strategies, beyond doses, require additional research.

Special Lecture

A History of Psychedelic Research in Canada

Erika Dyck, PhD, MA, BA, Professor, Canada Research Chair in the History of Medicine, University of Saskatchewan

In 1956 psychiatrist and superintendent of the Provincial Mental Hospital in Saskatchewan, Canada Humphry Osmond, first used the word ‘psychedelic’ to describe the feelings and sensations associated with an LSD drug reaction. A year later his new word was published and later added to the English lexicon after corresponding with literary genius, Aldous Huxley.

In spite of the popular connotations now connected to the word psychedelic, Osmond developed the term out of his experiments with colleagues at the University of Saskatchewan with LSD that led him to propose a new theory of schizophrenia alongside a somewhat radical suggestion to treat alcoholism using LSD. In contrast with many of his psychiatric contemporaries, these Saskatchewan researchers maintained that pharmacotherapies flourished most when combined with tenets of empathy, deference, and even ritual – features he learned from Indigenous ceremonies with plant medicines.

Although Osmond was not alone among his colleagues in the 1950s fascinated with the medical applications of psychedelics, his work in Canada brought him international recognition and made him a major figure in the history of LSD and addiction research, but also an awkward character in a looming countercultural revolution. LSD was banned from use by the late 1960s for a combination of moral and scientific reasons, but new developments in the 21st are encouraging policy makers and researchers to revisit these historical studies.

This presentation examines some of the historical Canadian trials with LSD, while it remained a legal substance, and considers how the drug and its supporters dealt with challenges, first from the medical community and later from political and moral authorities concerned about the abusive characteristics of psychedelic drugs.

Brief Presentations

OAT Series 2: New Ideas and Thought Leadership

This session includes six presentations examining new ideas and thought leadership in opioid agonist therapy.

Examining the Association Between Opioid-Related Mortality and History of Surgical Procedure: A Population-Based Case-Control Study

Mhd. Wasem Alsabbagh, BSc. Pharmacy, PhD, Assistant Professor, University of Waterloo, School of Pharmacy
Leona Spasik, PharmD candidate, University of Waterloo, School of Pharmacy
Mike Beazely, PhD, Associate Professor, University of Waterloo, School of Pharmacy

Researchers examined the association between surgery and opioid-related mortality in the Canadian population, and found that people who died of opioid-related causes were more likely to have had surgery in the four years before their death. They conclude that appropriate monitoring of post-surgical patients may help reduce opioid-related mortality.

A Descriptive Comparison of Factors Surrounding Opioid-Related Deaths Between Northern Public Health Units and Ontario Before and During the COVID-19 Pandemic

Amanda Perri, PhD, MSc, Epidemiologist, Algoma Public Health

The Hope to Health iOAT program views carried doses of iOAT as a tool to help stabilize clients. The restrictive approach to carried methadone doses is not an appropriate model to impose on short acting prescribed opioids. Ensuring clients have reliable medicine with sufficient frequency and dosage is part of culturally safe and humble medical practice.

Hope to Health iOAT Program: A Culturally Safe and Humble Approach to Improve Satisfaction and Retention

Edward Rooke, MD, CCFP, CISAM, Physician, BCCfE Hope to Health Clinic and FNHA Substance Use Service

A META:PHI working group has created a new framework for decision making regarding take-home dosing that reflects current literature, lived expertise and principles of patient-centred care. This session will be useful for those looking for evidence to inform dialogue and decision making about take-home doses in the current environment.

Bound to Pain: How Opioids Induce Pain that Perpetuates Use

Launette Rieb, MD, MSc, CCFP(AM), FCFP, CCSAM, DABAM, Clinical Associate Professor, University of British Columbia

In her practice, Dr. Launette Rieb noticed that patients sometimes reported that old, healed and typically pain-free injuries would hurt again temporarily after abrupt opioid cessation. She proposes that this withdrawal-associated injury site pain (WISP) may be a clinical correlate of opioid-induced hyperalgesia, and will discuss research that shows WISP may be a hidden driver of the opioid epidemic that needs to be addressed if we are to relieve suffering.

Association of Prescription of Oral Stimulant Medications on Cocaine Consumption Among a Population of Patients Receiving Opioid Agonist Treatment

Mark Tatangelo, BA, PhD, MBA, Analyst, NOSM
Kristin Morin, BA, MPH, PhD, Post Doctoral Fellow, NOSM
David Marsh, MD, CCSAM, Physician, NOSM
Farah Tahsin, BSc, Trainee, University of Toronto

The concurrent use of cocaine could be negatively associated with treatment efficacy, outcomes, and retention on opioid agonist therapy (OAT), which is concerning since 30-50% of OAT patients self-report cocaine use. The objective of this study was to measure the association of prescribed oral stimulants on the consumption of cocaine among a population of patients receiving OAT. Researchers found associations of age, male gender, and prescription of oral stimulants over time, on reductions of cocaine-positive urine tests.

Real-World Evidence for Impact of OAT on Non-Fatal Overdose in Patients with OUD during the COVID-19 Pandemic

Ken Lee, MD, MCFP, Physician, St. Joseph’s Health Care London
Yue Zhao, MD, PhD, Dr.P.H, Director, Biostatistics, Indivior
Tazmin Merali, BPharm, MBA, Chief Scientific Officer, Drug Intelligence
Jan Kozicky, MHA, PhD, Medical Science Liasion – Western Canada, Indivior
Brian Conway, MD, FRCPC, Medical Director, Vancouver Infectious Disease Centre

Researchers tracked 301 patients with substance use disorder who were treated with extended-release buprenorphine (BUP-XR), buprenorphine/naloxone sublingual tablets (BUP-SL) or methadone (MET). Patients were 65% male, median age 38. Over half had a history of injecting opioids and one in three had overdosed.

The study followed patients for six months during which no fatal overdoses were reported.

  • In the BUP-XR cohort, 88% stayed in treatment, 14% used fentanyl and 1% overdosed.
  • In the BUP-SL cohort, 68% stayed in treatment, 9% used fentanyl and 7% overdosed.
  • In the MET cohort, 81% stayed in treatment, 55% used fentanyl and 16% overdosed.


Researchers concluded that the use of BUP-XR was associated with a lower incidence of non-fatal overdose events as compared to BUP-SL and MET.

Trainee Session

Stories of Lived Experience: a Trainee-Guided Discussion

Wiplove Lamba, MD

In this storytelling workshop, three individuals who identify as people who used addictive substances will share their stories and their pathways to better health. A discussion on what was helpful and harmful in their recovery will ensue. This will be followed by a question and answer period where the audience can ask about how to improve their clinical work with people who use addictive substances.

Panel Discussion

Psychedelics in the Treatment of Addiction: A Panel Discussion of the Good, the Bad and the Unknown

Ronald Fraser, MD, FRCPC, Associate Professor, McGill University
Robert Tanguay, MD, FRCPC, Clinical Assistant Professor, University of Calgary
Nicolas Garel, MD, FRCPC, Fellow in Addiction Psychiatry, Standford University

Can psychedelics help to treat refractory mental health and addictive disorders? This panel discussion will survey the current state of the field, look at potential therapeutic benefits specific to the treatment of addiction, as well as potential risks and concerns. Moderators will encourage discussion, questions and the sharing of perspectives.