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Problematic substance use: Your options for treatment

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What’s the big deal?

Substance use is very common among Canadians. Most of us use at least one substance, such as alcohol, pot, or cocaine, and it can be an important part of social life. But when your substance use leads to a hospital visit, it’s a sign that it is causing problems in your life.
It can be very difficult to accept that your substance use is problematic, and it’s normal to feel ashamed, frightened, or angry. But the good news is that medical treatment for problematic substance use is safe and effective. This pamphlet contains information about the treatment options you’ll be offered at the rapid access addiction medicine (RAAM) clinic to help you manage your substance use.
For more information, please visit www.metaphi.ca.

What’s a RAAM clinic?

Rapid access addiction medicine (RAAM) clinics are drop-in clinics for people looking for help with their substance use. The people working at these clinics know how difficult it is to ask for help. You don’t need an appointment to attend this clinic – just show up during clinic hours with your health card.

Your history

The clinic team will begin by asking you about your history of alcohol use: when you started drinking, how much and how frequently you drink, the ways in which drinking has affected your life, and so on. Try to remember the clinic team is not there to judge you, and will be most able to treat you if you’re completely open about your drinking. The point of these questions is not to make you feel guilty or defensive, but to get a complete picture of you in order to determine how to help you.

Your diagnosis

Based on your history, the RAAM clinic team will provide you with a diagnosis. If you sometimes use substances excessively or problematically but are often able to use moderately, do not suffer serious social harms from using, and do not go through withdrawal when you stop using, the team may determine that your substance use is risky. On the other hand, if you often avoid your responsibilities due to substance use, have trouble using moderately, continue to use even when you know it’s a bad idea, and go through withdrawal when you stop using, the team may diagnose you with a substance use disorder. Both of these conditions are treatable.

Advice

Many people who have to go to the hospital for a substance-related problem have gotten injured as a result of using too much. In these cases, the clinic team will provide you with advice on how to make choices that will minimize the risks of use, such as tips on how to pace your use, harm reduction strategies, and situations to avoid.

Counselling

The RAAM clinic team may refer you to counselling as part of your treatment. Counselling can help people address the reasons for their drinking and come up with new and healthier ways to cope with difficult emotions. Counselling programs can include education on alcohol and healthy lifestyle choices, group and individual therapy sessions, help with developing coping skills, cognitive behavioural therapy, and peer support groups. The team will work with you to determine what form of counselling would be most helpful for you.

Medication

Addiction to some substances, such as alcohol or opioids, can be treated with medications that will help to reduce cravings, as well as the withdrawal symptoms that may accompany your early days of sobriety. Medication usually makes other types of treatment much more effective and reduces the risk of relapse. These medications are safe, effective, and non-addictive. If you are using opioids problematically, the RAAM clinic team may recommend buprenorphine or methadone, and if you have alcohol use disorder, you may be offered an anti-craving medication, such as naltrexone or acamprosate. The RAAM clinic team will explain what your options are and help you decide what would be the best choice for you.

Bring support

If you’re feeling anxious or hesitant about going to the RAAM clinic, consider bringing a supportive person with you. Changing your substance use can be very difficult, and having someone with you while you speak to the RAAM clinic team may make you feel less overwhelmed and less alone.

Toronto RAAM clinics

 (Due to COVID-19 outbreak, please call ahead)

Anishnawbe Health Toronto
179 Gerrard St. E (TEMPORARY LOCATION)
416-657-0379 ext. 234
Mon. 9:00 a.m.–12:00 p.m., Wed. & Thurs. 1:00 p.m.–4:00 p.m. (Indigenous patients)

Michael Garron Hospital
825 Coxwell Ave., 1st Floor, admitting/registration
416-469-6580 ext. 2517
Virtual care only – please call

North York General Hospital
(Addiction services for York Region partnership)
4001 Leslie St., 8th Floor
289-221-4839 or 1-888-399-8342
Mon. 12:00 p.m.–2:00 p.m., Wed. 10:00 a.m.–12:00 p.m. (virtual care)

St. Joseph’s Health Centre
30 The Queensway, 1st Floor
416-530-6486 ext. 3969
Tues. & Thurs. 10:00 a.m.–11:30 a.m.

Sunnybrook Health Sciences Centre
2075 Bayview Ave., Room A146
416-480-6736 or raamclinic@sunnybrook.ca
Virtual appointments available Mon. 5:00 p.m.–7:00 p.m., Wed. 2:00 p.m.–4:00 p.m., Fri. 10:00 a.m.–12:00 p.m.

Centre for Addiction and Mental Health
100 Stokes St., 3rd Floor
416-535-8501 (Access CAMH)
Mon., Wed., & Fri. 10:00 a.m.–2:00 p.m.

St. Michael’s Hospital FHT

St. James Town Health Centre
410 Sherbourne St., 1st Floor
416-864-3082
Wed. 12:00 p.m.–4:00 p.m. (pregnant patients)

St. Michael’s Hospital
30 Bond St., 17th Floor, CC Wing
416-864-3082
Mon., Wed., & Fri. 9:00 a.m.–11:00 a.m.

Humber River Hospital
(Addiction services for York Region partnership)
1235 Wilson Ave., 5th Floor
289-221-4839 or 1-888-399-8342
Tues. 3:00 p.m.–5:00 p.m., Thurs. 12:30 p.m.–2:30 p.m. (virtual care)

Toronto Western Hospital
399 Bathurst St., 1st Floor, WW1-414
416-726-5052
Mon. & Wed. 9:00 a.m.–11:00 a.m., Fri. 1:30 p.m.–3:30 p.m.

Women’s College Hospital
76 Grenville St., 3rd Floor
416-323-7559 ext. 6
Mon., Tues., & Thurs. 10:00 a.m.–12:00 p.m.

For more information, please visit www.metaphi.ca