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Accessible and barrier-free: MGH opens new Rapid Access Addictions Medicine Clinic
Mental Health and Addictions Services at Michael Garron Hospital has a new addition: the Rapid Access Addictions Medicine (RAAM) Clinic.
The clinic operates on Tuesdays and Fridays from 9 - 11 a.m. The RAAM Clinic welcome referrals but also allows patients to “walk in” during clinic hours in order to provide accessible care for those seeking medical help with addictions and substances misuse.
The Clinic opened in April 2018 as a joint project between the Emergency Department and the Toronto East Health Network Withdrawal Management Centre and offers short term medical treatment and counselling for all substance use disorders for adults. It aims to better integrate addiction care into the hospital and local primary care system as well as connect patients to longer term treatment.
“Clients with substance misuse often end up in the emergency room because you can just walk in without an appointment,” says Wendy Fenomeno, the manager of the RAAM Clinic, Community Mental Health Services and withdrawal management services.
Wendy, who is a registered nurse, has always been passionate about mental health and addictions services.
“For me it's always been about helping the clients. They just speak to me, their strength of character, their courage but also their vulnerabilities,” says Wendy. “I've always been angry with how society treats people who suffer with mental health and addictions issues.”
The MGH RAAM clinic team is made up of four physicians who work on rotation and two addictions counselors.
Dr. Kate Lazier is one of those physicians. She also helped develop the RAAM Clinic.
“In the ER we see so much addiction – overdoses, trauma, withdrawal, mental health issues and so on. We manage the acute emergency well but the underlying substance issues remain,” she says. “What we do at the RAAM Clinic is start a path towards a much more holistic and effective long term treatment that can help people stay out of the emergency department.”
In the Clinic, Dr. Lazier assesses the addiction problem and makes recommendations on medical treatment options.
“For alcohol use disorder there are a number of medications we can use to help patients with cravings and to cut down or eliminate use. With opioids, substitution therapy with suboxone is very successful,” she says.
As a family physician in the RAAM Clinic, Dr. Lazier helps clients with their clinical needs.
“When clients come in, I can see what they need medically and prescribe medication to help with cravings or withdrawal. I also see the physical symptoms they might be experiencing,” she says.
The RAAM Clinic also serves as a resource for family physicians in the community. Physicians can refer their patients here for access to addictions services.
In addition to seeing a family physician, clients of the RAAM Clinic will see an addictions counselor during their visit.
Jason Hunter is one of the two counselors. He also works at MGH's Withdrawal Management Centre.
“I'm there to help clients navigate the options available to them and figure out what their goals are,” he says. “We go over their substance use history, what the client's current needs are and what goals they may have for themselves".
Working with the goals of the client rather than setting goals for them is part of the RAAM Clinic philosophy.
Jason has been working at as an addictions counselor for ten years at MGH's Withdrawal Management Centre. He started there as a student.
“A great thing about the RAAM clinic is it provides people with really easy access to information about where they can go for help with addictions,” he says. “We can start planting the seeds of treatment options like referring them to the various services of the Withdrawal Management Centre; the men's residential program or one of the outpatient programs like the Day Withdrawal Program or Community Withdrawal which provides one on one counselling.”
The RAAM Clinic has seen a number of clients so far and the support received at the Clinic has helped many achieve their goals whether it's abstinence, developing a plan of care, education around anti-craving medications or reducing substance use and harm reduction
“The great thing for me in working in both places is seeing how fluid the transitions are. Clients move back and forth between the two services,” says Jason. “The staff who work in the RAAM Clinic and the staff working at the withdrawal site work together really well,”
“We've had four clients start having success because the RAAM Clinic was able to refer them to withdrawal management services. It's really amazing to see how the two sites can work together to help a client start achieving their goals.”
A hope of all of the RAAM clinic's staff is to continue to form relationships with other areas of the hospital and the community to help guide clients towards the resources they need.
Mental Health Services at Michael Garron Hospital works in partnership with clients and community members to provide a range of care options both on the main hospital campus and in other affiliated site in the East Toronto community. An interdisciplinary team of physicians, psychiatrists, nurses, occupational therapists, psychologists, psychometrists, social workers, mental health workers, case managers, and addiction workers will work in partnership with clients to achieve their recovery goals. Offsite areas of care include the Withdrawal Management Centre which maintains a residential program and a day-program. MGH's Aboriginal Healing Program, led by Elder Little Brown Bear, combines western and traditional methods of healing to support community members. The RAAM Clinic is the latest addition to our broad range of services.