Addiction Practice Pod

In this episode, award-winning journalist David P. Ball and First Nations Health Authority’s Medical Officer, Mental Health and Wellness, Dr. Nolan Hop Wo discuss the impact of stereotypes related to Indigenous people and alcohol use. Together, they speak with Beryl Parke, a Traditional Wellness Worker at First Nations Health Authority. Beryl is from the Haida Nation and belongs to the Sangalth Stastas Eagle Clan and is currently working in the Kwakwaka’wakw Territory on the lands of the We Wai Kai people in Cambell River, BC. Drawing on her personal experiences and knowledge from practicing in remote First Nations communities, Beryl discusses the importance of alcohol harm reduction and compassionate substance use care.You can find additional resources and clinical pearls in the show notes: bit.ly/APP-S4E6Art by Nevada Lynn

In this episode, award-winning journalist David P. Ball and award-winning family physician Dr. Robert Fox speak with Kali Sedgemore, the president of the Coalition of Peers Dismantling the Drug War and a skilled harm reductionist with a focus on supporting youth. Together, they discuss reasons for youth substance use and considerations for providers when meeting and caring for young people who use drugs. Kali also speaks to the intersection between Indigenous identity and safer access to substance use care, and about the strengths and resilience of youth.You can find additional resources and clinical pearls in the show notes, including the article on youth harm reduction calls to action mentioned in the episode: bit.ly/APP-S4E5Art by Satsi Naziel

In this episode, award-winning journalist David P. Ball and family physician Dr. Esther Tailfeathers speak with Maura Gowans, a counselling consultant for Indigenous people, about the role that connection to culture can play in healing and wellness. Together, they discuss the importance of bringing together traditional Indigenous approaches and Western approaches to substance use care in the context of the toxic drug crisis. Maura also describes how she creates safe spaces for clients and embeds cultural practices into her life and clinical practice. You can find additional resources and clinical pearls from the episode in the show notes: bit.ly/APP-S4E4Artwork by Satsi Naziel

Addressing the health needs of individuals in remote and rural Indigenous communities, as well as Indigenous people living in urban areas, requires a shift from Western-centric solutions. To emphasize the diversity of Indigenous Peoples, tailored and culturally-relevant approaches are crucial. This can include mobilizing peer and family support, recognizing the significance of culture, Elders, spirituality, and building community capacity through sustainable funding of Indigenous-led programs. In this episode of the Addiction Practice Pod, award-winning journalist David P. Ball and family physician Dr. Esther Tailfeathers discuss the realities of substance use care in Kainai Nation, a rural community where Dr. Tailfeathers works. We also hear from Helen Knott, award-winning author and founder of Indigenous wellness program Fierce With Heart, about her own healing journey and relationships to substance use, the land, and health care systems. You can find additional resources and clinical pearls from the episode in the show notes: bit.ly/APP-S4E3Artwork by Nevada Lynn

Navigating abstinence-based perspectives in substance use care can be complex. Within Indigenous communities, these complexities also intersect with the impacts of colonialism. Abstinence-based perspectives may arise or align with Indigenous teachings, they may stem from imposed colonial values, or both may be true. It is important to recognize that there are a variety of explanations for why abstinence-based approaches may be promoted, and that these can offer a healing path for individuals when aligned with Indigenous worldviews. In this episode of the Addiction Practice Pod, award-winning journalist David P. Ball and First Nation Health Authority’s Medical Officer of Mental Health and Wellness, Dr. Nolan Hop Wo, discuss potential benefits and harms from abstinence-based approaches to substance use care. We also hear from Keshia Cleaver, Harm Reduction and Program Advisor with The Four Directions Team at First Nations Health Authority, on why abstinence-based perspectives are common in some Indigenous communities, and how to meet communities where they are at with harm reduction. You can find additional resources and clinical pearls from the episode in the show notes: bit.ly/APP-S4E2Artwork by Brianna Bear

The ongoing impacts of colonization continue to affect the health and wellness of Indigenous Peoples, evident in the disproportionate rates of toxic drug poisonings and deaths experienced by Indigenous people as compared to non-Indigenous people. Addressing the harms related to substance use in these communities involves acknowledging and reducing the harms of colonialism, while emphasizing and building upon the strengths and resilience of Indigenous Peoples.In this episode of the Addiction Practice Pod, award-winning journalist David P. Ball speaks with the Medical Officer of Mental Health and Wellness at First Nations Health Authority, Dr. Nolan Hop Wo, on how colonialism and substance use are related. We also hear from Lacey Jones, Program Director of QomQem Coastal Connections, on strengths-based approaches to reducing the harms associated with colonialism. You can find additional resources and clinical pearls from the episode in the show notes: bit.ly/APP-S4E1Artwork by Brianna Bear

Families, including chosen families, can be an extremely important source of support in a person’s substances use care journey, but are often overlooked in substance use care planning. In this episode of the Addiction Practice Pod, co-hosts David Ball and Christina Chant discuss the complexities and strengths of involving families in substance use care. In a slight departure from usual programming, Christina is joined by her sister, Lauren Chant, to provide their unique perspectives as both clinicians and family members with years of experience navigating the health care system. We'd love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep6

Prescribed safer supply aims to provide access to a legal and regulated supply of drugs, in order to reduce the risk of harms and death associated with using the increasingly toxic unregulated drug supply. In this episode of the Addiction Practice Pod, Dr. Marcus Greatheart and journalist David Ball discuss prescribed safer supply with guests who have on-the-ground experience.First, we hear from harm reduction nurse educator Corey Ranger, on the concept of a “safer supply”, and steps clinicians can take to make prescribed safer supply programs more effective. Corey also shares some lessons learned from participants at the Victoria SAFER Initiative, a prescribed safer supply program in Victoria, BC. From Safer Opioid Supply (SOS) in London, Ontario, Dr. Andrea Sereda discusses the importance of listening to your client’s needs when it comes to their substance use, including what they need to reduce their reliance on the unregulated supply, and shares some preliminary data from SOS. We also hear from the co-founder of the Coalition of Substance Users of the North (CSUN), Jenny McDougall, on the importance of providing lower-barrier care options for individuals who are experiencing harms from the unregulated drug supply. We'd love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep5

Through providing small doses of alcohol to clients regularly, managed alcohol programs reduce the risks associated with heavy drinking and non-beverage alcohol consumption without requiring abstinence. In this episode of the Addiction Practice Pod, Dr. Marcus Greatheart and David Ball talk with public health researcher and executive director of the Vancouver Area Network of Drug Users, Brittany Graham, about the purpose of managed alcohol programs and how they fit into the continuum of care for alcohol use disorder. We also hear from harm reduction advocate and peer leader, George Sedore, about what led him to join a managed alcohol program and how this has impacted his life. We'd love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep4

Urine drug testing (UDT) is an important part of providing care to individuals with substance use disorders, from confirming baseline substance use to evaluating treatment outcomes. However, many individuals have had negative experiences with UDT. When UDT procedures feel punitive, it can impact whether an individual will continue to access care.In this episode of the Addiction Practice Pod, Dr. Marcus Greatheart and David Ball talk with family nurse practitioner Tracey Day about how to effectively communicate with a patient about UDT and build a care plan collaboratively. We also hear from peer navigator and clinical care advocate Reija Jean, on the impact of negative UDT experiences, and how care providers can build respectful and safe therapeutic relationships.We'd love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep3

Individuals and communities in BC are facing an increased risk of stimulant-related harms. Stimulant use can cause significant harms on its own, including negative cardiac and mental health outcomes. In the context of the unregulated drug supply, toxic drug poisonings can occur due to contamination of stimulants with opioids and other substances. In this episode of Addiction Practice Pod, Dr. Marcus Greatheart and David Ball talk with addiction psychiatrist Dr. Julius Elefante about harm reduction and treatment for stimulant use disorder. We also hear from the executive director of UNDU, Katt Cadieux, on the importance of trusting your patient and building a care plan based on their lived experience. We'd love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep2

Alcohol withdrawal management is an important part of the continuum of care for alcohol use disorder. While some individuals at low risk of complications can safely undergo alcohol withdrawal at home, others may require inpatient withdrawal management services to prevent life-threatening complications.In this episode of Addiction Practice Pod, Dr. Marcus Greatheart and David Ball talk with clinical nurse specialist Avee Khela about alcohol withdrawal management pathways, and we hear from Sandra Stewart on the importance of compassionate, non-judgemental care.We’d love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep1

In Canada and around the world, colonial histories continue to influence people's access to determinants of good health. Our society continues to advantage White people, and addiction medicine is no exception. In this episode, Dr. Robert Fox, David Ball, and their guests discuss the intersections of race, ethnicity, and substance use. How can we make our clinics more accessible for people of different racial and ethnic identities? How can we unlearn our own racial prejudice? In this episode, we use the term ‘racialized’ to indicate groups who are marginalized according to race as a part of their identity.We’d love to hear your feedback after the show. Find our evaluation, along with our show notes here: https://bit.ly/3uJPAe2

Evidence-based treatments often focus on a specific type of substance, like opioids or stimulants. However, many people have more than one substance that they use frequently.In this episode, Dr. Lindsay Mackay, David Ball and their guests talk about co-occurring substance use and its implications in clinical care. In particular, they discuss co-occurring substance use as it relates to gender and to stigma in the clinic.We’d love to hear your feedback after the show. Find our evaluation, along with our show notes here: https://bit.ly/3LciDfR

When it comes to treatment for substance use disorders, there’s no silver bullet. Medications can be important to support people with their recovery goals, but psychosocial treatments can provide a different kind of support and ensure medications provide the most benefit possible.In this episode, Christina Chant and David Ball talk with guests about psychosocial treatment approaches for substance-related harm. What do psychosocial treatments look like in practice, and how do they support people to improve their health in relation to substance use?We’d love to hear your feedback after the show. Find our evaluation survey, along with our show notes here: https://bit.ly/3FBxpsQ

Co-occurring chronic pain is common among people with substance use disorders, particularly opioid use disorder (OUD). Studies suggest that between 36 and 68% of people on opioid agonist treatment for OUD also have chronic pain. In this episode, Dr. Rita McCracken and David Ball talk with guests about chronic pain and OUD. How can we respond to new or changing pain for people already on opioid agonist treatment? How can we navigate pain treatment for people with OUD in the context of the overdose crisis? We’d love to hear your feedback after the show. Find our evaluation survey, along with our show notes here: https://bit.ly/3rdOFRd

Alcohol use is highly prevalent, but there is still a lot of stigma associated with alcohol use disorder. In this episode of the Addiction Practice Pod, Dr. Roland Engelbrecht and David Ball talk with guests about alcohol harm reduction, treatment, and the impacts of alcohol use disorder on family and loved ones.We’d love to hear your feedback after the show. Find our evaluation survey, along with our show notes here: https://bit.ly/3wECCx5

The overdose crisis is affecting all parts of the country, but the majority of research has focused on major cities, and the majority of services are located there too. In this episode of Addiction Practice Pod, Dr. Robert Fox talks with guests about substance use care in rural and remote contexts.We’d love to hear your feedback after the show. Find our evaluation survey, along with our show notes here: https://bit.ly/30ZqhZ0

Nearly five British Columbians are dying every day of an overdose, but Indigneous peoples in our region face disproportionate harms: If you’re Indigenous, you are four times more likely to die of an overdose than the rest of the populationIn this episode, family physician and addiction medicine specialist Dr. Robert Fox and journalist David Ball discuss why clinicians should be mindful of the disproportionate impact of overdose crisis on Indigenous peoples, and best practices to address the disparity.We’d love to hear your feedback after the show. Find our evaluation survey, along with our show notes here: https://bit.ly/3DZ9FP1

The criminalization of substance use causes demonstrable harms: it isolates people who use drugs, pushes them to use in riskier ways, and deters them from seeking help when they need it. Even so, the possession of illicit street drugs for personal consumption is still criminalized in British Columbia and the rest of Canada.In this episode, addiction physician Dr. Christy Sutherland and journalist David Ball discuss the years-long overdose crisis in British Columbia, how the criminalization of substance use negatively impacts lives and health, and what role clinicians can play in reducing these harms in the absence of systemic change.We’d love to hear your feedback after the show. Find our evaluation survey, along with our show notes here: https://bit.ly/3p5yOS8