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Affecting change in addiction medicine

Posted on :  September 18th, 2018  |  By :  Robby Breadner


Dr. Mike Franklyn ~ Addiction physician, Health Sciences North, Sudbury.

Dr. Michael Franklyn wears many hats in the field of medicine. As a family doctor in Sudbury for almost 25 years, Dr. Franklyn recalls fearing for the life of a female patient in 2002; she was using methadone and forced to travel weekly to Toronto for care. With only one addiction specialist in Sudbury at the time, the wait list for local treatment was about two years. “Then, I had no background in addiction medicine. But out of my complete frustration with the inability to get help for her in the north, I had to go learn about addiction care and it has since become a huge part of my life and my practice,” he said.

As a family doctor and Associate Professor at the Northern Ontario School of Medicine (NOSM), Dr. Franklyn says about 70 per cent of his time is now focused specifically on addiction medicine. While his home base is in Sudbury, Dr. Franklyn is one of several doctors who fly into remote northwestern Ontario First Nations to treat patients in their home communities, where no other treatment is offered. He also uses OTN to service 13 remote communities in northwestern Ontario.

In Sudbury, Dr. Franklyn is Medical Director of the local Rapid Access Addictions Medicine (RAAM) Clinic, one of seven in Ontario. As the only clinic of its kind in the north, Dr. Franklyn notes it as a “very successful model” where patients with any type of addiction can be seen by an addiction expert within 48 hours. The clinic, which opened in December 2015, was originally funded as a provincial pilot program to offer individuals dealing with addictions earl and assertive treatment, while alleviating burdens on other points of care.

Franklyn noted the financial benefits (of treating addictions) to the province’s health-care system. Treating patients at the RAAM Clinic has demonstrated reduction in their use of local ambulance services, emergency room visits, detox and in-patient admissions. “These are all very expensive interventions,” he said. “By addressing the underlying cause of addition, we dramatically reduce utilization of the system, and are actually doing something that is likely to help the patient.”

According to statistics from the Canadian Centre for Substance Abuse, addiction is a health issue that impacts millions of Canadians. It causes harm to individuals, families and communities. Conservative estimates (from the 2012 Canadian Community Health Survey) found that 4.4 per cent of Canadians met the criteria for a substance-use disorder. Dr. Franklyn adds that there are almost 50,000 people in the province on methadone, and that that only one in three people who are dependent on opiates are seeking help. “The situation is fundamentally worse and more complex than it was just two years ago,” he said.

In what Franklyn calls the current “opiate crisis,” it’s important now more than ever to jump in with both feet. While working in remote fly-in northern First Nations communities his team will spend an entire week with a group of patients addressing their addictions. People lives are literally transformed in the week that starts their recovery journey.

For Dr. Franklyn and his colleagues, seeing the impact they have on people’s lives is the most rewarding aspect of the work. “I love everything I do…but there’s too much to do,” he said.

When asked what keeps him going back to work each day, Dr. Franklyn says it’s the triumph. “There are times where this field of medicine is incredibly frustrating, but just seeing the successes is what keeps you going.”

Originally published on the Ontario Medical Association’s Spotlight on Health.


What it’s like being a methadone doctor

Posted on :  December 19th, 2017  |  By :  Robby Breadner
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Written by Dr. John Crosby – November 28, 2017 for canadianhealthcarenetwork.ca

I recently had lunch with Dr. Andrew Worster, an old friend from my emergency days 25 years ago. He works at an opioid addiction clinic in Cambridge, Ont., and still does ER shifts at Hamilton General Hospital. He works in the ER one or two eight-10-hour shifts per week but doesn’t do night shifts any more so he enjoys the two jobs. He has been practising for 26 years and also runs a non-profit corporation called BEEM — Best Evidence in Emergency Medicine — which conducts evidence-based emergency medicine courses for emergency doctors worldwide.

Andrew works in the addiction clinic on Monday morning and all day Wednesday. It is a private business and they help patients get healthcare cards He says that 70% of the patients are functioning, with jobs and families.

Many patients start with chronic pain and about 50% work at physically demanding jobs, hence, they use opioids to get through the day’s work as their bodies are wearing out on the job. They start small and gradually require higher and higher doses for relief.

Andrew said he feels opioids are sometimes appropriate for short-term severe pain but not for non-cancer chronic pain.

Andrew noted that doctors and the patients have to accept that in life there will be pain. In the ER, he often gets patients who tell him that their GP has done nothing for their back pain. For ER patients with severe, debilitating pain, he sometimes uses ketamine (15mg I.V. over 15 minutes) to break the cycle of pain and spasm but does not prescribe opioids upon discharge… Click here to read the entire article.


Hamilton music community hosts overdose training as opioid crisis grips city

Posted on :  November 27th, 2017  |  By :  Robby Breadner
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Photo credit: Google.

Event happened at This Ain’t Hollywood in downtown Hamilton tonight.

“Ace Piva knows the dangers of opioid addiction all too well.

He’s seen it up close — both as a tour manager across Canada, and as an addictions counsellor in Hamilton.

Now, as overdoses and deaths due to opioid use continue to mount across the city, Piva has launched an addiction and recovery nonprofit organization specifically for the music industry. It’s called Over the Bridge — a nod to the Red Hot Chili Peppers’ breakout hit Under the Bridge, which was written about addiction, loneliness and dependency.

Tonight, Piva is hosting a naloxone training and overdose prevention awareness event at This Ain’t Hollywood, in an effort to save lives in an industry where the party rarely stops…”

By Adam Carter, CBC News – Read full story on CBC website, here.


CATC – partnering to improve lives of patients

Posted on :  October 15th, 2017  |  By :  Robby Breadner

CATC – partnering to improve lives of patients.

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Click the video or here to view.


Recovery Day to bring awareness, support and hope

Posted on :  October 2nd, 2017  |  By :  Robby Breadner

Tara Edeh from the Ontario Addiction Treatment Centres and founder of Recovery Day, Annie McCullough shed light on Recovery Day dedicated to help out people coming out of any kind of addictions. – video courtesy of BT Breakfast Television.

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Toronto police issue safety alert after four suspected fentanyl deaths

Posted on :  July 31st, 2017  |  By :  Robby Breadner

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Toronto police say there have been four deaths due to fentanyl and 20 incidents of fentanyl overdose since Thursday [within three days].

“Toronto police have issued a public safety alert after four deaths likely caused by fentanyl overdose in the past three days in downtown Toronto.

Police said there have been four fatalities and 20 overdose incidents since Thursday.

The most recent incident was on Saturday when a woman was found dead in a stairwell near Queen St. E and Trefann St.

A 27-year-old man died on Thursday in the area of Queen St. W. and Bathurst St., where he allegedly overdosed on heroin laced with fentanyl, a powerful opioid that’s about 50 times stronger than heroin…” — excerpt from thestar.com, by Bryann Aguilar, Alanna Rizza. July 29, 2017.

Read the full article, here.

Mayor John Tory comments on “tragedy”.


A highly successful treatment for opioid addiction. But stigma is holding it back.

Posted on :  July 26th, 2017  |  By :  Robby Breadner

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“Medication-assisted treatment is often called the gold standard of addiction care. But much of the country has resisted it.

If you ask Jordan Hansen why he changed his mind on medication-assisted treatment for opioid addiction, this is the bottom line.

Several years ago, Hansen was against the form of treatment. If you asked him back then what he thought about it, he would have told you that it’s ineffective — and even harmful — for drug users. Like other critics, to Hansen, medication-assisted treatment was nothing more than substituting one drug (say, heroin) with another (methadone).”  – Updated by German Lopez, Vox.com

Read the full article here on website: Vox…


The Influences on Addiction

Posted on :  July 6th, 2017  |  By :  towardsrecovery

Harm reduction is one of the foundations of addiction treatment. This applies not only to drug addiction but also alcoholism, compulsive gambling, and even eating disorders. The treatments should also take into account the influences on addiction like the biological, psychological, social, and even spiritual aspects. These are even discussed in the book Addiction Treatment a Strengths Perspective. Let us try to look at these influences.

Methods of Treatment

There have been many new methods of treatment for drug addiction that have surfaced in recent years. Unfortunately, the treatment centers do not fully go into the influencing factors that help develop the addiction. Even some of the treatments are considered as superficial.

There are basically two types of influences, biological and environmental. Both of these are found in the Biological-Psychological-Social-Spiritual (BPSS) addiction model. In recognizing these influences, like any other disease, it becomes easier to uncover the weak point where the addiction was able to penetrate a person’s life.

Why are there so many addiction models? These models help in understanding the causes of drug addiction as well as assist in the recovery process. In essence, this creates an effective treatment program. This is essential especially when we consider that there is a lack of certainty on what really causes addiction.

As experts continue to debate on the most effective approach to treatment and recovery, the BPPS model can offer some insights. The Biological aspect can answer the question why, the Psychological is the what, and the Social is the where that defines the cycle that every drug addict goes through. What about the spiritual? It is believed that every addict has to go through some form or spiritual healing or connection to a higher power to be able to withstand the challenges of addiction.

Multiple Causes

By adhering to the model described in the Addiction Treatment a Strengths Perspective, there is an acceptance that the addiction not only has multiple causes, but also multiple solutions. This holds true considering that every case of addiction can be considered unique to the person experiencing it.

Human diversity plays a huge role in the process of addiction, treatment, recovery, and sustainability. And every person will need to go through a personalized program as a sort of personal recipe that will lead to successful recovery.

The BPSS model therefore can be considered an incomplete solution. The importance of the model is that it will help experts to understand and figure out how the problems can be fixed. By reducing the addiction problem to model size, it becomes easier to understand its different stages. This helps to ensure that important details are not lost in dealing with issues of addiction and recovery.  In this aspect, it makes no sense to argue what addiction model is best, but only to make use of each to uncover how recovery can be implemented on every individual addict.

These models actually give us many explanations on the multiple causes of addiction. Each of these models also propose its own model of recovery that is based on the presumed cause that resulted in the addiction. As these models leave some aspects of recovery out of the picture, it is up to the addict to fill in the highly relevant details to create a complete recovery scenario. This means that the cooperation of the addict in the treatment process is extremely significant. It also gives the addict a free hand to choose what recovery treatment he feels would be most beneficial and relevant to him.

Causes of Addiction

Evidence-based practices have revealed many possible causes of addiction. Numerous research works have given supporting evidences on how treatment programs have been effective in curbing an addiction. There is no shortage of research that helps to establish the causes of addiction that can also lead to other types of addiction. For example, alcoholics can become, after some time, addicted to illegal or prescribed drugs as well.

The models try to present the bridge that links these addictions together. In this example, alcohol becomes the influence that triggers the drug addiction. So if you combine the addiction model with that for drug addiction, you will be able to successfully address all of its causes. This is why you do not have to choose the best or correct model. You simply need to select what applies to the personal condition of the addict.

Different people will obviously make different choices. These choices will be based on their circumstances and specific needs. Towards Recovery Clinics can help addicts make the right decision through its holistic treatment approach. Call them now!


Frequently Asked Methadone Treatment Questions

Posted on :  May 18th, 2017  |  By :  towardsrecovery

Despite being one of the most popular treatment methods for opioid dependence, there are still a couple of questions surrounding the use of methadone. It is understandable considering that not everyone agrees with the implementation of methadone treatment. To give you a better understanding, let’s take a look at some methadone treatment questions.

What is Methadone?

This is the most basic question that anyone should ask about the treatment. Basically, it is a type of drug used not only for the treatment of opiate addiction, but also for relieving pain. It is important to point out that methadone is strictly used for opioid related addiction and not applicable for other types like cocaine, marijuana, or alcohol among others.

What does it do?

Methadone works by blocking the receptors of the brain that is affected by the use of heroin and other opiates. This allows addicts to achieve gradual detoxification without the violent withdrawal symptoms. This means that methadone will occupy the receptors to block high opiates and achieve a more stable feeling. The addict will have reduced cravings and tempered withdrawal symptoms that lowers the risk of relapse. This is done by simulating the same sense of euphoria that opiates deliver but with longer lasting effects so that a single dose a day would be sufficient for most addicts.

Is the Treatment Safe?

There are obvious concerns when it comes to the safety of the treatment. However, when methadone is used as it is prescribed, it can be safely taken even continuously over a number of years without experiencing dangerous side effects. Methadone has also gone through rigorous testing to ensure its safety and efficacy when applied as a treatment for narcotic dependence and withdrawal.

As a type of legal medication, its production is handled by licensed pharmaceutical companies subjected to strict monitoring and quality control standards. The administration is also supervised by a physician using strict guidelines. As far as mental impairment, intoxication, or feeling of sedation, none of these are associated with methadone so patients can continue to pursue normal and ordinary activities.

Is the Treatment Effective?

For over 30 years methadone has been used for the effective treatment of opioid dependence and addiction. To back up its claims of effectiveness, numerous scientific research works have been done. One such study was done in 1994 where a methadone maintenance treatment was linked to lower rates of criminality, illegal drug use, and hospitalization of addicts compared to other popularly used drug treatment programs.

Are there Side Effects?

What kind of side effects can you experience when going through the program if any? If we are to base on studies, there are no significant side effects that can be expected from the medically supervised implementation of the methadone treatment. Most common reports include water retention, skin rash, drowsiness, constipation, excessive sweating, and change in libido. The side effects disappear once that patient gets the proper individual dosage.

What are the Benefits?

Aside from what has already been stated, safe and effective, one desirable benefit of the methadone treatment program is that it is the most affordable choice for most opiate addicts. Other benefits are the relief from withdrawal symptoms, return of chemical balance, reduced cravings, and emotional balance. All of these benefits will result in the return of normal bodily functions, improved relationships, and overall stability of the patient.

Will it Show on Drug Tests?

If your concern is turning positive on drug tests, then you will be happy to know that methadone does not return a positive unlike heroin or morphine. Specific testing for methadone should be done to be able to detect its presence in your system. The good news is that this type of specific testing is not normally done. In the United States, supervised methadone maintenance programs fall under the Americans with Disabilities Act so it cannot be used as a basis for denying employment.

There are definitely more methadone treatment questions creeping in your mind. To get the right answers, contact Towards Recovery Clinics now.


Methadone Treatment History

Posted on :  May 1st, 2017  |  By :  towardsrecovery

Did you know that methadone was first produced during the mid-1900s? It came about as part of the research into the development of new pain relieving drugs that can be used as an alternative to morphine. In fact, it has been one of the more popularly researched drug treatments all over the world. The social context however is that it is prescribed as a way of prohibiting opiate use, making it more complex than other medication around.

The Development

A German scientist was responsible for the development of the chemical structure of methadone during the 1930s. The production of the synthetic substance in 1937 was led by Gustav Ehrhart and Max Bockmhl, and was called polamidon (Hoechst 10820).

Their research was expanded during World War II as the original medicine was synthesized as a response to the morphine shortage. As the war ended, the United States obtained the rights to the drug now called methadone. It was in 1947 when it was introduced in the US as a type of pain relieving medicine for various conditions. This led to the belief that it could be used in the treatment of narcotics addiction.

Scientific advancements came during the 1960s, and by the early part of the 1970s the methadone treatment started to expand with the government setting up the necessary regulations that will govern the use of methadone as part of a drug addiction treatment program.

Additional regulations were released in 2001 to modify the existing regulations to cover the manner of delivery of methadone to ensure better control.

The Opioid Addiction

Believe it or not, many of the abused substances today including opioids (morphine, opium, heroine, and other prescription opioids) were initially dispensed as curative measures by physicians, pharmacists, and other members of the healthcare community. Many of these were the basic ingredients of commercial products for cough suppressants, pain killers, and even beverages.

There was no doubt that the products delivered the intended results initially, until abuse eventually happened. A good example would be opioids which were best in relieving pain on the battlefields during the Civil War. The uncontrolled use however along with advertised benefits for nonmedical use led to its tolerance and addiction.

Tolerance means that the body starts needing larger quantities and more frequent usage of the opioid, usually in combination with other substances in order to get a sustained effect. This also leads to more severe withdrawal once the addiction is not fully satisfied.

Recognition of the problem opened up debates among those affected, the healthcare profession, the government, and the community leaders. The discussion centered on the incurable nature of opioid addiction, which required long-term maintenance with medication, and opioid addiction as a result of weak, lack of morals, and psychodynamic factors that requires criminalization of its uncontrolled use and distribution to promote abstinence.

Treatment Issues

Since its development in 1964 as a medical response to the post-war heroin epidemic, there have been plenty of major studies conducted. The findings in these major studies were all consistent in that methadone maintenance treatment successfully reduces or eliminates:

  • The use of heroin;
  • The transmission of infectious diseases related to heroin injection;
  • The death rates; and
  • Criminality associated with drug usage.

It also allowed the patients to gain improved health and social productivity. It has been established that the principal effects of the treatment are:

  • Relieving of narcotic cravings;
  • Suppression of the abstinence syndrome; and
  • Blocking the euphoric effects delivered by heroin.

Specific dosages of methadone are required by patients and should be administered for an extended period of time (sometimes indefinitely) because of the nature of the methadone treatment, which is corrective rather than curative. Using lower doses may not yield the desired blocking effect. There should be no fear since methadone treatment has been established to be medically safe.

Government is advocating the expansion of the methadone maintenance treatment program with newer models to be implemented. The National Institutes of Health even recommended that the treatment program be made available to persons that are under legal supervision like parolees, the incarcerated, and probationers.

The educational leadership should be provided by the professional community to ensure the general public that the stigma and bias against the programs are unfounded. These should move the expansion forward.

To ensure that you are getting in the right treatment program for your addiction, get a hold of Towards Recovery Clinics.




Who We Serve ?

  • Individuals using/abusing street narcotics (e.g. heroin).
  • Patients abusing prescription narcotics(i.e., Codeine, Talwin, Percocet/Percodan, Dilaudid, Morphine or Demerol, et cetera).
  • Individuals displaying any of the following behaviours: Compulsive drug use or drug seeking/craving.
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