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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.


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…


Hepatitis C Treatment

Posted on :  January 9th, 2017  |  By :  Robby Breadner

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Hepatitis C Treatment FACT SHEET

  1. Contact the Towards Recovery (www.towardsrecovery.com has all the contact information listed) or walk-in during regular business hours
  2. Required to have a valid health card.
  3. Inform the staff in the clinics that you are here for information about Hepatitis C Treatment.

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Overview of the treatment:

  1. All clients on the program or not will be tested for Hepatitis C
  2. If they are Hepatitis C positive, they MUST be tested for the type of Hepatitis C and the amount of Virus (Genotype/Viral Load):
    There are two possible results – the bloodwork will come back with both GT and a Viral Load OR the Viral Load will be “undetected” (meaning that it is either too early to detect, or their body has cleared the virus themselves).
    TIP: Should re-test at 6 months if the results are “undetected”
  3. If an active virus is present we need to do more bloodwork to find out how much fibrosis is in the liver.
    Currently in our clinics we are testing via a blood test (there is also a Fibroscan which can be used (similar to an ultrasound, but test is not covered by OHIP) – if the bloodwork comes back with a Fibroscore of 2 or higher – both private and public insurance is apt to cover all the treatment costs.
  4. 4If F2 or higher Towards Recovery will make a referral for an ultra sound.
  5. Towards Recovery will then send documentation requesting approval for medication coverage.
  6. After approval is received by Towards Recovery, the client will then start on the treatment.

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Pharmacological Information:

Currently at Towards Recovery we are working with 2 different Pharmaceutical companies.

  1. Gilead – Hepatitis C products – Sovaldi / Harvoni
  2. AbbVie – Hepatitis C product – Holkira Pak

Depending on the type of Hepatitis C, previous treatment, and level of cirrhosis will dictate the length of treatment – current treatment can run as little as 8 weeks and as long as 24 weeks.

Please contact Towards Recovery for further details.

The PDF of this Fact Sheet can be downloaded. Click here.




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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