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Category: Unit 2

Unit 2 Assessment

Part 1

In searching for scholarly literature, I found that searching under well known journals was helpful to get credible information right away.  Going the Google route brought up many articles mostly of a news nature and not scholarly literature. There is a lot in the news right now regarding opioids and overdose but not too much on treatment.

Part 2

The authors and their credentials are as follows; Dr. Sarah Wakeman M.D., is the Medical Director, Substance Use Disorder Initiative, Program Director, Addiction Medicine Fellowship and Assistant Professor of Medicine, Harvard University; Dr. Michael Barnett, M.D., assistant professor at the Harvard T. H. Chan School of Public Health. They are very credible authors.

The article was published in the New England Journal of Medicine, July 5, 2018. It was a perspective, not a full research study. This journal is one of the highest for credibility. The article is only 3 months old.

The intentions of the authors were to inform physicians in primary care of the myths and realities of treating opioid use disorder and the treatment options. The intended audience is family physicians.

The New England Journal of Medicine published the article in July 2018. All articles in this journal are peer reviewed before they can be published.

The authors both work in the addiction medicine field. They are fully aware on many practical levels of the ongoing crisis and difficulty in patients finding treatment. They are very credible specialists that were advocating for family physicians to start treating addiction in their practices to help open access to treatment. The article is very practical discussing the realities, myths and possible policy responses as well.  It is well written.  Although they are American, the issues are very similar in Canada right now. The practical medical advice would transfer for use here.

Wakeman, S. E., & Barnett, M. L., (2018) Primary Care and the Opioid-Overdose Crises –  Buprenorphine Myths and Realities, New England Journal of Medicine, July 2018, 379;1 file:///C:/Users/Owner/Downloads/NEJMp1802741%20Primary%20Care%20Treatment.pdf

 

Part C

I will use many different sources of information. For the introduction I will look up some of the statistics from Canadian government sources such as provincial health reports of overdoses. I will look up published guidelines of how and where opioids should be used. I will find articles on how many patients go through emergency departments. I will try and contact the RAAM clinics individually to get up to date statistics.

When reading some of the research it will be important to understand who and where the research has come from. There are many philosophical ideas about treatment of addiction.  It is an area that is just starting to apply evidence-based treatment instead of what was done in the past. It is a huge shift.  I have been involved in the addiction medicine realm for some time and know most of the key opinion leaders. I am aware of the centers that do research and the high-level journals. Hopefully that will be useful. 

Do you think that research of a medical nature can be applied to the Canadian landscape even if it was carried out in another country?

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Concept Mapping

 

 

The concept map is separated into two sections. The top section has my personal interests. I do a lot of reading in this area, mainly books and articles. Of interest is how a person can thrive in today’s busy world. I am particularly interested in how the mind and body are interconnected from a wellness and health perspective and how coaching can assist a person for best outcomes.

The bottom section involves my professional life. I have been in the addiction medicine world from a medication assisted treatment perspective.  It is interesting to see how complex and interconnected opioids are from many different perspectives on the Canadian Landscape. Each connecting line could be at least one study. There is a crisis happening right now in Canada with an average of 11 people dying every day of an opioid overdose. It is difficult for people to find help and know where to go if they run into trouble and what the outcomes are.  There are many entry points for individuals to take opioids.

The concept map from the opioid circle spreading out could be a potential answer to the research questions of; How are opioids interconnected? How do people get addicted to opioids? Where can individuals find treatment for their opioid addiction? What are the outcomes of newly set up Rapid Access Addiction Medicine (RAAM) clinics in Ontario? Here are a few more formal questions;

  1. What are the factors for someone to become addicted if prescribed an opioid for pain? (Chronic vs. acute pain, timeframes, history of mental illness or other addictions)
  2. Ontario is moving to a model of Rapid Access Addiction Medicine (RAAM) clinics, what are the success rates of this model? (Number of ER’s using this type of service, number of patients served, GP acceptance of continuing a patient in treatment.)
  3. What is the patient experience of getting opioid addiction treatment in family practice?
  4. Why is navigating treatment options for opioid addiction so difficult? What information systems need to be I place for a patient to be informed of where to get treatment for opioid addiction?
  5. What differences are there in the paths women vs men take when 10 – 15 years pre-retirement?
  6. Do women experience a re-purposing after their children are independent?

 

The strongest research question is the second one regarding RAAM clinics. The province of Ontario is starting to get them up and running. It would help to know if patients get into treatment sooner than later. Do RAAM clinics reduce wait times at hospital emergency departments? Is there an overall cost saving by having this specialized clinic? Only some hospitals have access to them currently. It would be interesting to see during this time of change the difference RAAM clinics make. Do they live up to the promise.

If followed through, it would involve searching many broad fields of literature, such as current RAAM Clinics, healthcare, government and funding models, addiction overdoes statistics, addiction treatment, emergency departments and LIHNS. Of concern would be getting current information when RAAM clinics are relatively new.

 

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