Addiction medicine: working smarter, not harder
When it comes to caring for people who use substances, Dr. Lisa Heidt strives to support health-care staff to work smarter, not harder. For the past 15 years as an emergency department (ED) physician at the Vernon Jubilee Hospital (VJH), Dr. Heidt knows all too well how hard inpatient staff work in this busy hospital.
“I know that staff are doing the best job they can with limited resources,” says Dr. Heidt. “...but I think it is possible to improve both patient care and staff satisfaction with the resources we have available, even as we work to improve access to resources over the long term.”
Learn more about Dr. Heidt
Patients who use substances are three times more likely to leave inpatient care against medical advice (AMA), and patients who leave AMA are 12 times more likely to return within 14 days with a related health concern (CrismPrairies, 2020). Some of the core reasons for leaving AMA include undertreated withdrawal, cravings and uncontrolled pain (Simon et al, 2020).
Active untreated opioid withdrawal is a medical emergency and should be treated as such. It is crucial we recognize acute care as an opportunity to engage people in the continuum of addiction care, including harm reduction, to decrease adverse outcomes including unintentional fatal opioid overdose.
On her recent transition to addiction medicine, Dr. Heidt initially wasn’t well trained in providing addiction care. “But with an improved knowledge base, I realized how much more effective I could be,” she says. “That felt really empowering, as it was contributing to the presenting complaint in such a large proportion of my ED patients. It gradually became the most satisfying part of my job.”
In 2022, Dr. Heidt decided to pursue an addiction medicine fellowship on Vancouver Island. Since then, she has started an Addiction Medicine Consultation service at VJH, where she works closely with the nurses, psychiatrists, hospitalists, and ED physicians.
Dr. Heidt is working on several projects to support knowledge about the treatment of substance use disorders. She recently hosted weekly VJH staff sessions on topics including acute withdrawal management, alcohol use disorder and withdrawal, opioid agonist treatment guidelines, suboxone inductions, and harm reduction. She is currently involved in Physician Quality Improvement (PQI) Cohort 6.
Along with her dyad partner, Tracy Spedding, they aim to improve screening rates for substance use disorders, with the hypothesis that by front loading resources and treatment, adverse patient safety events such as aggression, overdose, and in-hospital substance use can be mitigated, while engagement in potentially lifesaving treatment can be optimized.
Resources
Email the harmreduction.coordinator@interiorhealth.ca to enquire about IH harm reduction/addiction medicine groups.
Addiction Care and Treatment Online Course.
Other stories in this series
- Harm Reduction Physician Series: Dr. Megan Hill
- A nurse practitioner’s experience with harm reduction
If you are a physician or nurse practitioner (NP) who would like to be featured in our harm reduction series, contact harmreduction.coordinator@interiorhealth.ca.
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