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What it’s like being a methadone doctor

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

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
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.



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



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, 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


“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,

Read the full article here on website: Vox…

Hepatitis C Treatment

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


Hepatitis C Treatment FACT SHEET

  1. Contact the Towards Recovery ( 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.


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.


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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