- Many harm reduction supply programs have closed due to COVID-19
- The VAN provides mobile harm reduction supply services
- Every night 7:00 pm to 11:00 pm
- Patients can text/call 905-317-9966 to arrange.
- For anyone self-isolating due to COVID-19 infection and unable to access supervised consumption sites, discuss options for phone/virtual overdose prevention services:
- National Overdose Response Service: 1-888-688-NORS (6677). NORS is an overdose prevention hotline for Canadians.
- The Brave App: A virtual overdose prevention service in your pocket, so you don’t have to use alone.
Considerations for Alcohol Use Disorder
- Alcohol Withdrawal Management
- If a patient is self-isolating and will be abruptly ceasing alcohol consumption, discuss their alcohol withdrawal risk (see pg. 16 of META:PHI Handbook) and plan accordingly
- If low risk for a complicated alcohol withdrawal, consider outpatient withdrawal management with diazepam or lorazepam. See this AAFP article for some guidance on fixed-dosing regimens: https://www.aafp.org/afp/2013/1101/p589.html
- If a patient is high risk (history of delirium tremens or alcohol withdrawal seizures, age > 65, significant medical co-morbidities, advanced cirrhosis, limited social supports) outpatient withdrawal management would not be recommended and they may require hospital admission
- If a patient is not self-isolating but is interested in supervised withdrawal management, Men’s Addiction Services of Hamilton (MASH) (Tel: 905 527-9264) or Womankind (Tel: 905-545-9100) are available.
Considerations for Opioid Use Disorder
- See the META:PHI / CAMH / OMA guidance document on prescribing of opioid agonist therapy in the context of COVID-19
- If a patient on opioid agonist therapy is self-isolating due to COVID-19 infection, consider the following strategies to ensure continuity of care during their period of self-isolation:
- Consider exceptional take-home doses during the period of self-isolation to reduce the risk of destabilization due to missed doses. For patients who may not be appropriate for self-management of take-home doses, work with pharmacy to arrange daily delivered OAT doses with the option of virtual video witnessing.
- Offer phone or video appointments for dose titration or re-assessment during the period of self-isolation
OTN Addiction Medicine Consultation
Help is available! Drs. Robin Lennox and Lori Regenstreif are available by OTN econsult. OTN telemedicine visits with patients can also be arranged.
Compiled by Dr. Jennifer Brasch, Addiction Psychiatry
12 Step Online Meetings
AA Sober Living
Online recovery help for those in all stages of recovery, family, friends and loved ones including message boards, chats, blogs, and daily and weekly readings.
This website includes message boards, chat rooms, online meetings, and an online library of recovery resources.
In the Rooms
A free online recovery tool that offers 130 weekly online meetings for those recovering from addiction and related issues. They embrace multiple pathways to recovery, including all 12 Step, Non-12 Step, Wellness and Mental Health modalities.
The Daily Pledge
This is Hazelden Betty Ford Foundation’s free online Community Social Site. It provides a home page to make a Daily Pledge to sobriety with healthy daily activities to help people see others “recover out loud.”
The site also includes a Discussions forum, Chat, Online Meetings, Fun and Photo sections, private messaging with other members, and other interactive involvements. You need to sign-up to participate.
The message board in this directory of recovery resources covers a wide variety of categories: Newcomers, Ask the Experts, General Forums, Alcoholism (AA, Alanon, ACOA), Drug Addiction (NA, Nar-Anon), Family and Friends, Mental Health and much more.
This free online drug rehab group was originally set up just to help those trying to quit marijuana but they now welcome anyone struggling with drug addiction.
HAMS Harm Reduction Network
HAMS is a free of charge peer led support group for people who want to reduce the harm in their lives caused by alcohol or other substances. HAMS offers support via a chat room, an email group, and live meetings. HAMS supports every goal from safer use to reduced use to abstinence from alcohol. Their daily chat is schedule for 9 P.M. EST, 6 P.M. PST.
Compiled by Robin Lennox except where noted above, March 26, 2020