Methamphetamine Client Transitions to Primary Care Detoxification/Recovery Centre to Primary Care Pathway and Toolkit

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Methamphetamine Client Transitions
 to Primary Care
 Detoxification/Recovery Centre to
 Primary Care Pathway and Toolkit

 www.pcnconnectmd.com/clinical-referral-pathways/

 Poundmaker’s Lodge
 Treatment Centres

 Financial contribution from

The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada
Methamphetamine Client Transitions to Primary Care
 Detoxification/Recovery Centre to Primary Care Pathway and Toolkit
 At admission, Detoxification/
 Recovery Centre (D/RC) asks if client
 has a Primary Care Provider (PCP)
 Yes, but they can’t
 Yes, but they do not feel remember PCP or
 comfortable disclosing Yes clinic name
 Yes

 Client has primary care
 provider?
 D/RC asks again at a later Yes No D/RC checks Netcare or
 opportunity other sources
 D/RC asks for consent to
 notify PCP that client has D/RC refers to Attachment
 been admitted Protocol
 No
 PCP or clinic identified?
 D/RC explores reasons
 for refusal, provides Yes
 information or education, Client consents to share
 and asks again at a later information with PCP?
 No
 opportunity
 Yes

 D/RC notifies PCP of rmed
 admission and confirms Not Confi D/RC discusses non-
 confirmation with client
 relationship

 Confirmed
 D/RC begins discharge
 planning

 D/RC will discharge client to home If client self-discharges prior to
 D/RC will discharge client completing discharge plan D/RC
 after completing detoxification
 to treatment centre sends notification of discharge to
 period
 PCP

 Client wants to see their No
D/RC sends information on client’s
 PCP after discharge?
PCP to treatment centre for post-
 treatment follow-up Yes
 D/RC sends primary
 care clinic notification
 D/RC and/or client schedules of discharge/discharge
 D/RC sends primary care clinic follow-up appointment summary
 notification of transition to with PCP
 treatment centre/treatment date

 D/RC provides client appointment D/RC and client meet
Roles and Responsibilities: reminder /call with PCP
 Detoxification/Recovery Centre
 Detoxification/Recovery Centre
 D/RC sends primary care clinic
 and Client
 notification of discharge and
 Client discharge summary
 Detoxification/Recovery Centre
 and Primary Care Provider
 Client and Primary Care Provider
 Client attends follow-up
Abbreviations appointment with PCP
D/RC - Detoxification/Recovery Centre
 Page | 2
PCP - Primary Care Provider
Methamphetamine Client Transitions to Primary Care
 Detoxification/Recovery Centre to Primary Care Pathway and Toolkit

 PROCESS DETAILS WHERE/WHO IS INVOLVED? SUPPORTING RESOURCES
 OR TRAINING

At admission, Detoxification/ • If the client does not recall • Detoxification/Recovery Centre • First Nations Community
Recovery Centre (D/RC) Team information about their PCP, it Health Centres: https://
Member asks client if they have a is important to remember that informalberta.ca/public/
 » Client
Primary Care Provider (PCP) they may be overwhelmed and service/serviceProfileStyled.
 feeling unwell at admission and » D/RC Triage or Admission Team do?serviceQueryId=1005212
 may not be able to provide this Member
 • College of Physicians and
 information when asked. It is » May be asked by another team Surgeons of Alberta - Find a
 recommended that this question member if asked at a later Physician website:
 be asked again at a later date opportunity https://search.cpsa.ca/
 when the client is more stable.
 • Consider using language that
 may be more familiar to the
 client. You could use terminology
 such as family physician,
 general practitioner (GP),
 nurse practitioner (NP), health
 care worker, most responsible
 provider (MRP) or you could ask
 about the clinic or health centre
 where they access services.

Client has a PCP? • If the client has a PCP, but they • Detoxification/Recovery Centre • Appendix A - FAQs: The
 cannot remember the PCP or Importance of Primary Care and
 clinic name: the Patient’s Medical Home for
 » Client Clients with Methamphetamine
 - Consider checking other
 sources such as previous » D/RC Triage or Admission Team Concerns
 charts, available EMRs Member • College of Physicians and
 (Netcare, ConnectCare, Surgeons of Alberta - Find a
 etc.) or contact the client’s » May be asked by another team
 member if asked at a later Physician website:
 pharmacy to obtain
 https://search.cpsa.ca/
 information on their PCP. opportunity
 - It is recommended to ask • Alberta Find A Doctor website
 again at a later date as clients https://albertafindadoctor.ca/
 who are seeking detoxification
 • Methamphetamine Client
 or stabilization services are
 likely unwell and/or anxious Transitions to Primary Care -
 and may be unable to recall Attachment Protocol
 this information at admission. https://www.pcnconnectmd.
 • If the client has a PCP, but com/wp-content/
 they do not feel comfortable uploads/2021/04/
 disclosing: MethAttachmentProtocol.pdf
 - Clients may have a variety of
 reasons why they do not feel
 comfortable disclosing this
 information to other health
 care providers. It may be
 helpful to provide information
 on why it is beneficial to
 involve their PCP in their care
 and reassure clients that it is
 their decision whether their
 PCP is involved.
 - If possible, ask again at a later
 date as the client may feel
 more comfortable disclosing
 at a later opportunity.
 - Clients may prefer to
 disclose their involvement
 with an alternate health
 care provider who they feel

 Page | 3
PROCESS DETAILS WHERE/WHO IS INVOLVED? SUPPORTING RESOURCES
 OR TRAINING

Client has a PCP? more comfortable sharing
(Continued) this information with. The
 nature of this relationship may
 allow for the topic of sharing
 information with a PCP to be
 revisited in the future.
 • If the client does not have a PCP,
 the Methamphetamine Client
 Transitions to Primary Care
 Attachment Protocol provides
 guidance on how to connect
 clients to a PCP. Information
 can be shared with the client to
 explore on their own or a
 D/RC Team Member can assist
 the client to register on the
 albertafindadoctor.ca website.

D/RC Team Member asks for • If the client has a PCP, the D/RC • Detoxification/Recovery Centre • Health Information Act (HIA)
consent to notify PCP that client has Team Member seeks consent https://www.alberta.ca/health-
been admitted from the client to notify their information-act.aspx
 » Client
 PCP that the client has been
 • HIA Consent to Disclose Form
 admitted for detoxification/ » D/RC Triage or Admission Team
 https://www.alberta.ca/assets/
 stabilization. Member
 documents/hia-section-34-
 • Client consent can be » May be asked by another team consent.pdf
 documented using the Health member if asked at a later
 Information Act (HIA) Consent opportunity
 to Disclose Form or through
 consent forms provided by the
 organization.
 • Team members are encouraged
 to ask for consent for this
 notification to occur as
 a courtesy to the client.
 However, there are limited
 circumstances where consent
 may not be needed to provide
 information to another health
 care provider. It is important to
 follow organizational processes
 regarding sharing client
 information with other care
 providers.

Client consents to share information • If the client does not consent to • Detoxification/Recovery Centre • Appendix A - FAQs: The
with PCP? sharing information with their Importance of Primary Care and
 PCP, it is encouraged to explore the Patient’s Medical Home for
 » Client
 the client’s reasons for refusal Clients with Methamphetamine
 and provide any information » D/RC Team Member Concerns
 or education that may help to
 • HIA Consent to Disclose Form
 address their concerns.
 https://www.alberta.ca/assets/
 • Consider asking again at a later documents/hia-section-34-
 opportunity as the client may consent.pdf
 change their mind.

 Page | 4
PROCESS DETAILS WHERE/WHO IS INVOLVED? SUPPORTING RESOURCES
 OR TRAINING

D/RC Team Member notifies PCP of • If the client consents to sharing • Detoxification/Recovery Centre • Appendix B - Detoxification/
admission and confirms relationship information with their PCP, the Recovery Centre Admission
 D/RC Team Member sends the Notification and Primary Care
 » Client
 Detoxification/Recovery Centre Provider Confirmation
 Admission Notification and PCP » D/RC Triage or Admission Team
 • Alberta Find A Doctor website
 Confirmation (Appendix B) to the Member
 https://albertafindadoctor.ca/
 PCP via preferred communication » May be asked by another team
 methods (i.e. fax, email, • Methamphetamine Client
 member if asked at a later
 telephone). Transitions to Primary Care -
 opportunity
 Attachment Protocol
 • If confirmation of the » Primary Care Provider https://www.pcnconnectmd.
 relationship does not occur, a
 com/wp-content/
 discussion with the client may be
 uploads/2021/04/
 warranted to inform them of this
 MethAttachmentProtocol.pdf
 outcome.
 • If it is determined that the client
 does not have a PCP and they
 wish to be connected to one,
 the Methamphetamine Client
 Transitions to Primary Care
 Attachment Protocol provides
 guidance on how to connect
 clients to a PCP. Information
 can be shared with the client to
 explore on their own or
 D/RC Team Member can assist
 the client to register on the
 albertafindadoctor.ca website.

D/RC begins discharge planning • D/RC Team Members work • Detoxification/Recovery Centre • Appendix C - Detoxification/
 in collaboration with the Recovery Centre Discharge
 client to develop a discharge Notification
 plan following organizational » D/RC Team Member
 processes. Clients may be • Appendix D - Detoxification/
 » Client
 discharged: Recovery Centre Discharge
 - Home after completing their Summary
 detoxification/stabilization • Appendix E - Treatment Centre
 period. Notification
 - To a treatment centre. In
 this instance, information • Appendix F - Meth Check: Ultra
 about the client’s PCP should Brief Intervention Tool
 be communicated to the
 treatment centre for post- • Meth Check: Ways to Stay Safe
 treatment follow-up. If a booklet (Insight)
 client will be transitioning to https://www.pcnconnectmd.com/
 a treatment centre, it is also wp-content/uploads/2021/03/
 recommended that the D/RC MethCheckBooklet.pdf
 Team Member notify the PCP
 via preferred communication • Meth Check: Harm Reduction
 methods (i.e. fax, email, Wallet Cards (Insight)
 telephone). https://www.pcnconnectmd.com/
 - By choosing to self discharge wp-content/uploads/2021/03/
 prior to completing discharge MethCheckHarmReductionCards.
 planning. This outcome should pdf
 be communicated to the
 client’s PCP for follow-up.

Client wants to see their PCP after • If the client does not want to see • Detoxification/Recovery Centre • Appendix C - Detoxification/
discharge? their PCP after their discharge from Recovery Centre Discharge
 the program, the D/RC sends the Notification
 » Client
 PCP or clinic the Detoxification/
 • Appendix D - Detoxification/
 Recovery Centre Discharge » D/RC Team Member
 Recovery Centre Discharge
 Notification (Appendix C) and the » Primary Care Provider Summary
 Detoxification/Recovery Centre
 Discharge Summary (Appendix
 D, if appropriate) via preferred
 communication methods. The
 client is discharged as per the
 discharge plan.

 Page | 5
PROCESS DETAILS WHERE/WHO IS INVOLVED? SUPPORTING RESOURCES
 OR TRAINING

D/RC Team Member and/or client • If the client would like to see • Detoxification/Recovery Centre
schedules follow-up appointment their PCP after their discharge
with PCP from the program, they should
 » Client
 be supported with any resources
 required to facilitate this step » If requested, D/RC Team Member
 (i.e. a telephone or a quiet » Primary Care Provider
 room). Some clients may request
 a clinician to schedule this » Other Primary Care Team
 appointment on their behalf. Members, as appropriate
 Client preference should be
 accommodated as much as
 possible.
 • Some clients may have health
 complexities that warrant a
 conversation with their PCP prior
 to discharge. This conversation
 may involve the D/RC Team
 Member if necessary or requested
 by the client. This conversation
 should also be accommodated
 with any support or resources the
 client may need.

D/RC Team Member provides client • Clients may benefit from a written • Detoxification/Recovery Centre • Appendix G - Client Appointment
with appointment reminder reminder with details of their Reminder
 follow-up appointment with
 » D/RC Team Member
 their PCP, as well as any other
 follow-up appointments with care » Client
 providers.
 • Some clinics may designate a
 nurse or other practitioner to
 follow-up with a client after
 discharge from a detoxification/
 recovery centre. It is
 recommended to advise clients
 that they may be contacted prior
 to their appointment with their
 PCP.

D/RC sends PCP notification of • Upon discharge, the D/RC sends • Detoxification/Recovery Centre • Appendix C - Detoxification/
discharge and discharge summary the Detoxification/Recovery Recovery Centre Discharge
 Centre Discharge Notification Notification
 » D/RC Team Member
 (Appendix C) and Detoxification/
 • Appendix D - Detoxification/
 Recovery Centre Discharge » Primary Care Provider
 Recovery Centre Discharge
 Summary (Appendix D, if
 Summary
 appropriate) to the PCP or clinic
 via preferred communication
 methods.

 Page | 6
PROCESS DETAILS WHERE/WHO IS INVOLVED? SUPPORTING RESOURCES
 OR TRAINING

Client attends follow-up • Consider providing clients the • Primary Care Clinic Provider Resources:
appointment with PCP option of in person, virtual,
 • Primary Care Network • Appendix H - Quick Reference
 or telephone appointments
 as appropriate. Clients may Guide for Assessment and
 be experiencing barriers with » Client Management of Clients with
 transportation, finances, or Methamphetamine Concerns
 » Primary Care Provider
 internet/telephone access and • Appendix I - Changing How
 providing appointment options » Primary Care Team Members We Talk About Substance Use
 may increase their ability to (Government of Canada)
 attend.
 • Appendix J - Care
 • If clients are experiencing barriers Considerations for Clients with
 to care, consider involving team Methamphetamine Concerns in
 members such as a Social Worker, Primary Care
 Behaviour Health Consultant,
 • Appendix K - Team Based Care for
 or Mental Health Navigator
 Clients with Methamphetamine
 to provide support to clients
 Concerns
 to address these concerns.
 Resources may vary based on • Community Resource List
 your Primary Care Network. https://edmonton.cmha.ca/211-
 resource-lists/
 • Should a client miss their
 appointment, it is recommended • Caring for Clients with
 to follow-up with them prior to Methamphetamine Concerns
 instituting any no show fees or (My Learning Link and PHC
 other punitive measures. These Learning Portal)
 measures can inadvertently
 increase barriers for clients or Client Resources:
 discourage them from seeking • Appendix F - Meth Check: Ultra
 care. Brief Intervention Tool
 • Appendix L – Meth Check:
 Factsheet for Families
 • Meth Check: Harm Reduction
 Wallet Cards (Insight)
 https://www.pcnconnectmd.
 com/wp-content/
 uploads/2021/03/
 MethCheckHarmReductionCards.
 pdf
 • Family and Caregiver Resources
 (British Columbia Centre on
 Substance Use)
 https://www.bccsu.ca/family-
 and-caregiver-resources/?doing_
 wp_cron=1528042429.35175800
 32348632812500
 • Community Resource List
 https://edmonton.cmha.ca/211-
 resource-lists/

 Page | 7
Appendices

 APPENDIX A The Importance of Primary Care and

 FAQS the Patient’s Medical Home for Clients with
 Methamphetamine Concerns

 For clients who are connected to a family physician/ For clients who are not connected to a family
 nurse practitioner/physician’s assistant. physician/nurse practitioner/physician’s assistant.

Q: What is the benefit of my primary care provider knowing Q: Why do I need family physician/nurse practitioner /
that I am using methamphetamines? How can they help me? physician’s assistant? What is the benefit of having a primary
A: Sharing your methamphetamine concerns with your care provider in the community?
primary care provider is important. Using methamphetamine A: A family physician/nurse practitioner/physician’s assistant,
repeatedly can cause sleep disruptions; worsen mood and or “primary care provider” is someone you see regularly for
memory; and cause skin, dental, or heart issues. It can cause your healthcare needs. They support both your physical and
psychosis in severe instances. Your family primary care provider mental health. You can build an ongoing, trusting relationship
can work with you to recommend different treatments, with them and share difficult or complex concerns, such as
resources, and strategies based on your specific goals. your methamphetamine use, in a safe and non-judgemental
Whether or not you are ready to stop using methamphetamine environment. Having a regular primary care provider helps you
your primary care provider can also work with you to discuss get the best healthcare possible for your unique situation.
harm reduction practices that can help you stay safe while Q: What is a Primary Care Network?
you are using methamphetamine. Your primary care provider A: Primary Care Network, or PCN, is an organization that
can also connect you to a team of other health professionals supports primary care providers with a team of other health
including nurses and mental health providers. This team can care professionals, like nurses or mental health providers. For
help you with things like finding housing, obtaining ID, or example, your primary care provider may connect you with a
applying for income support; or address issues like anxiety, grief mental health provider at the PCN who can provide support
or trauma. These team members may be located within the with things like finding housing, obtaining ID, or applying for
same clinic that you see your primary care provider in or they income support. These team members may be located within
may be located at a Primary Care Network (PCN) office. the same clinic that you see your primary care provider in or
Q: Will my primary care provider report my drug use to the they may be located at a PCN office.
authorities? Q: What is a Patient’s Medical Home?
A: Your health information is confidential unless there is A: Your primary care provider and their team of health care
immediate or severe risk to yourself or others. These situations professionals work together to create a Patient’s Medical
are complex and there are often other things that can be Home, or PMH. This is a place where you can feel the most
explored prior to involving the authorities. It is important to comfortable to discuss your personal and family health
note that tests like urine drug screens are only ordered for concerns. When you are “attached” to primary care provider’s
medical purposes and cannot be released to the authorities Patient’s Medical Home it means that you will see them for
or used for legal purposes without your knowledge or written your regular medical care. A Patient’s Medical Home does
consent. not mean that you cannot access healthcare elsewhere in
Q: Can my primary care provider restrict my medications emergency situations but any follow up would occur with your
because I use methamphetamine? primary care provider.
A: Your primary care provider will not restrict your medications Q: I don’t have a primary care provider. How do I find one?
just because you use methamphetamine. There are some A: You can find a primary care provider through the Alberta
medications that are unsafe, or have dangerous side effects Find A Doctor website: (albertafindadoctor.ca).
when used at the same time as methamphetamine. Your You can type in a place that is easy for you to get to and select
primary care provider can work with you to explore the safest “accepting new patients” to find a primary care provider in the
medication options. They can also work with a pharmacist who area. You can also select gender and language preferences if
can help you to manage your medications and answer any you wish. You can then call the clinic, or clinics, to schedule a
questions. “Meet and Greet” appointment. You can also use the “Help Me
 Find a Doctor” tool on the website if you would like help. Fill
 out your information and someone will contact you to help you
 find a primary care provider.

 Page | 8
Appendices

 APPENDIX B

Detoxification/Recovery Centre Admission Notification
and Primary Care Provider Confirmation
Please be advised that your client,
 [name]

DOB (mm/dd/yyyy): PHN:

Has been admitted to:
 on
 [facility name] [mm/dd/yyyy]

Reason for admission:

 Alcohol use  Stimulant use  Opioid use Other:

Please confirm that you are the Primary Care. Provider (family physician/nurse practitioner/physician’s
assistant) of the client identified above and return this form to

[fax number]

 Yes, I am the Primary Care Provider for this client

 No, I am not the Primary Care Provider for this client

Note: If we do not hear back regarding the above inquiry, we will interpret it as confirmation that you are
the client’s the Primary Care Provider.

Should you have further questions or concerns, please contact our facility at
 [phone number]

 Page | 9
Appendices

 APPENDIX C

Detoxification/Recovery Centre Discharge Notification
Please be advised that your client,
 [name]

DOB (mm/dd/yyyy): PHN:

Has been discharged from:
 on
 [facility name] [mm/dd/yyyy]

Reason for discharge:

 Detoxification/stabilization period completed

  Discharge Summary attached

 Admitted to Treatment Centre/Sober Living facility
 Name of facility:
 Self-discharged

 Other:

Should you have further questions or concerns, please contact our facility at
 [phone number]

 Page | 10
Appendices

 APPENDIX D

Detoxification/Recovery Centre Discharge Summary
Client Name: DOB [mm/dd/yyyy]: PHN:
Admission Date [mm/dd/yyyy]: Discharge Date [mm/dd/yyyy]:

 Substance Frequency Amount Route Last Use

Physical health concerns (attach Medication List if applicable)

Mental health concerns

Discharge Plan:
 Discharge to home  Application to Residential Treatment/Sober Living submitted
 Facility/Organization:
 Discharge to other:
Client is connected to the following organizations:
 Boyle St. Co-op  AHS Addiction & Mental Health  Jasper Place Health and Wellness
 Streetworks Provider:  Opioid Dependency Treatment
 Hope Mission/Herb Jamieson  Narcotics Anonymous (NA)/ Facility :
 George Spady Society Alcoholics Anonymous (AA)/Crystal Meth  Psychologist/Psychiatrist/Counsellor
 Anonymous (CMA), etc.
 Homeward Trust Provider:
  NNADAP (National Native Addiction
 Forensic Assessment Centre (FACS) and Drug Abuse Program)  Other:

Follow-up appointments:
Date: Time: Location: Provider:
Follow-up appointments:
Date: Time: Location: Provider:
Follow-up appointments:
Date: Time: Location: Provider:

Naloxone Kit provided?  Yes  No
Should you have any questions or concerns, please contact our facility at
 [phone number]
 Page | 11
Appendices

 APPENDIX E

Treatment Centre Notification
Client:
DOB (mm/dd/yyyy):
PHN:

Please support in arranging post treatment follow-up with primary care.

Primary Care Provider is:
Clinic:
Contact information:

Other care providers the client is connected to and may wish to connect with post treatment:
Provider:
Organization/Facility:
Contact information:

Provider:
Organization/Facility:
Contact information:

Provider:
Organization/Facility:
Contact information:

Provider:
Organization/Facility:
Contact information:

 Page | 12
2 2 3 4 6 7
 3 7
 4
 3 4 6 WHAT ARE THE GOOD BITS WHAT ARE THE
 2
 The purpose of Meth Check WORKER'S NOTES
 METH is to provide you with ABOUT USING METH? NOT-SO-GOOD BITS?
 This tool is designed to help guide a
 conversation with someone who uses
 some useful information methamphetamine. It is not intended e.g. Sleep problems, feeling scattered, getting ripped off,
 2
 e.g. Having fun / excitement, coping with stress,
 to replace a full clinical assessment.
 and practical tips around Please consider all risk, safety, to help stay awake. fights, relationship bust-ups, money problems, hassles with
 CHECK 3
 work / study, getting busted, losing licence.
 methamphetamine. consent and confidentiality issues
 4
 before commencing. If now is not a
 It should only take about good time, this resource can be taken
 10-15 minutes to complete. away and read at a later date. A guide
 to using this tool can be found at
 www.insight.qld.edu.au
 NAME: DATE:
 ERE!
 START H
 2
 3 2
 A BIT ABOUT METH
 3 4 6 75 5
 APPENDIX F - METH CHECK: ULTRA BRIEF INTERVENTION TOOL

 4 DID YOU KNOW... WHAT TYPE OF METH DO YOU USE?
 Meth is a powerful stimulant drug. LOWER HIGHER
 It’s good to know the reasons why you use
 D (POWD SE (OILY) YSTAL ME
 / CR
 PURITY PURITY
 It can make you feel good and EE BA meth. It affects where, when, how much and
 ICE
 7
 ER
 SP

 TH
 how often you use it.
 3 4 66 7
 )

 increases your alertness and energy.
 It works by causing a huge
 2 2 3 4 DO YOU KNOW HOW MUCH YOU SPEND ON METH?

 Page | 13
 release of ‘dopamine’, the brain’s PLEASE TICK
 pleasure chemical.
 It is known by many different names These are all the same drug – methamphetamine –
 only the form and purity is different.*
 2
 – speed, ice, crystal, shard, tina, fast, You may need a calculator for this section:
 2
 goey, whizz.
 3
 Per week $ enter a dollar amount
 Powdered speed used to be
 amphetamine, but these days it 3
 TOP TIP
 4
 • The higher the purity the less you need.
 Per month $ multiply the weekly number by 4
 almost always is methamphetamine.
 4
 • Purity can change from batch to batch.
 Per year $ multiply the monthly number by 13 (to equal 52 weeks)
 5
 • All use carries risk.
 7
 After buying meth, do you find that you have enough money left over for daily expenses?
 6
 e.g. food, rent, transport, bills (please circle)
 2 3 4 Always Mostly Sometimes Rarely Never
2 HOW OFTEN HAVE
 ON A SCALE FROM 1-10, HOW WORRIED ARE YOU ABOUT YOUR USE?
3
 55
 DID YOU KNOW...
 TOP TIP 1 2 3 4 5 6 7 8 9 10
4
 Why did you give
 YOU USED METH The number of people
 who seek treatment for • The more frequently
 Not at all worried Very worried
 these scores?
 you use meth, the
 IN THE PAST methamphetamine use more problems you What would it
 12 MONTHS? at mental health and can experience. HOW IMPORTANT IS IT FOR YOU TO MAKE CHANGES TO YOUR USE? take for your
 addictions clinics has • If you find yourself score to go up or
 using meth every down?
 Weekly increased by almost 9 times week, you might be 1 2 3 4 5 6 7 8 9 10
 Appendices

 Monthly in the past 5 years?** ‘dependent’ on meth. Not important Very important
 Less than once per month GO TO 3
 Turn the page
 * There are also prescription medications which contain amphetamine or amphetamine-like substances (e.g. Ritalin, ‘Dexamphetamine’). over for more
 ** Alberta Health Services. (2020). Methamphetamine Dashboard. Alberta Health Services: Calgary, AB. information
 5
3 4 6 7 TO STAY SAFE
 TIPS
 6 7 THINKING ABOUT CUTTING BACK OR QUITTING?
 2 3 4 Most people successfully quit or cut back their use of meth all by themselves. Many find it easier with the support
 Would you try any of these strategies below? (or maybe you do them already?) of family, friends and/or health professionals. There is more than one way of changing – everyone is different and
 WOULD YOU... 2 YES MAYBE NO
 it’s important to think about what works for you.
 3

 https://www.pcnconnectmd.com/wp-content/uploads/2021/03/MethCheckInterventionTool.pdf
 TOO MUCH METH? CAN YOU THINK OF SOME PRACTICAL THINGS YOU CAN DO TO HELP YOU CUT BACK OR QUIT?
 4
 Set limits on how much you will use?
 Signs of a meth overdose include:
 If using a new batch, try a little bit first and • Severe headache
 wait before having more?
 • Chest pain
 Use around people you trust in a safe place?
 • Vomiting
 • Overheating
 If injecting, use sterile equipment?
 • Extreme agitation
 HERE ARE SOME OTHER TIPS... WHAT TO EXPECT
2 2
 2 3 4 26 37 4
 Be safe sex ready? (condoms and lube)
 6 7 Seek assistance immediately
 by calling 911 and ask for
 • REASONS – Write down why you want to quit or cut down. This could
 include money, saving a relationship, health benefits, etc.
 You can sometimes feel worse before you feel
 better. You may feel flat, anxious, irritable or
3 3
 5
 'AMBULANCE'. If someone is have trouble sleeping. Or you could find it more
4 4 unconscious and breathing, turn
 • SUPPORT – Make sure you have as much support as possible.
 of a challenge to get motivated or organised.
 5
 Try thinking of people who can support you.
 Before using meth - plan ahead. them on their side in the recovery These are normal responses to quitting and
 2 2 3 4 6MIND YOUR
 7 HEAD position. • CUES – Avoid things that will make you feel like using such as
 places, people and stressful situations. This is especially important
 are signs that your body is readjusting from
 using the drug. They will improve over time.
 3
 EAT
 7
 3 4 6
 in the beginning.
 Eat at least one meal per day and
 4 Some people who use Keep the airway clear • CUT TIES – Throw out anything you associate with using Is there someone you can trust - like a
 2
 preferably eat healthy (e.g. fruit, meth can experience
 (e.g. pipes, injecting equipment) and cut connections to people family member, friend or worker - who

 Page | 14
 smoothies, cereal + milk, soup, anxiety, low mood or feel
 pasta). associated with meth if possible (e.g. delete phone numbers). you can talk to about your meth use?
 ‘scattered’. Another effect
 2 DRINK
 of meth can be strange • CRAVINGS – Be prepared. These are uncomfortable but they will pass.
 3 or paranoid thoughts Knee stops body from – Delay making a decision on whether or not to use for 5 minutes
 45 7 5
 4 Drink water and stay hydrated. Limit or hallucinations (often rolling onto stomach
 or up to half an hour, or longer.
 2 3 6
 Hand supports head
 how much alcohol you consume. referred to as psychosis).
 – Distract yourself e.g. phone a friend, go for a walk, eat, listen to music.
 If this happens to you, it – Deep breathing or other relaxation techniques can help you stay calm.
 SLEEP could be a side-effect of If they are not breathing, perform
 Know when it’s time to take a break the drug and lack of sleep. CPR if you are able to and wait with
 Try and stay calm and find MY PLAN FROM HERE IS...
 5
 from using. If you can’t sleep, try to them until help arrives.
 have some downtime. a safe place to chill. Drink
 Don’t confuse sleep with loss of
 2 3 4 6 7
 water. Try to sleep. Make
 consciousness. If someone cannot
 DON’T MIX sure someone stays with
 2
 5 you. be woken up, it is likely they are
 3 Be aware of taking alcohol, opiates
 and benzodiazepines (e.g. Valium If these symptoms don’t
 unconscious.
 4 / sleeping pills) to help you sleep. go away, you may need to
 There is a risk of overdose from these seek professional help.
 drugs once the meth wears off.
 REMEMBER:
 5 DON’T DRIVE
 Meth can make you feel like you’re
 driving safer than you really are.

 Do you smoke cannabis?
 Be careful. Cannabis
 • Help is available. •
 • Treatment works.
 If you are trying to
 quit, sometimes
 can increase feelings of it can take a few
 Roadside drug testing can detect anxiety or paranoia or make • People can attempts. Learn
 meth in your saliva. psychosis worse. make successful from any slip-ups
 APPENDIX F - CON’T

 changes around and keep going.
 WHERE TO GO FOR MORE HELP... Your local service contact is: their meth use.
 5
 ARE YOU A PARENT? ARE YOU PREGNANT?
 Call the Addiction and Mental Health Helpline
 for free, confidential, 24/7 access to support,
 information and referral.
 Meth use can affect your children Using meth during pregnancy carries
 1-866-332-2322
Appendices

 and others around you. Ensure your increased risk including miscarriage
 children remain safe and supervised and birth defects. Talk to a medical
 at all times... Be prepared for the professional for advice.
 come-down. This resource has been modified for use in Canada. It was originally developed by Insight - Centre for Alcohol and Other Drug Training and Workforce Development,
 Queensland, Australia. Copyright 2021. All rights reserved. To learn more about Insight visit www.insight.qld.edu.au
Appendices

 APPENDIX G

Client Appointment Reminder
You have a follow-up appointment with [provider, including role]:

on [date] at [time] AM/PM

at [clinic or facility name]
Their clinic/facility is located at [clinic or facility address]

Your appointment will take place:
 In person  Virtual appointment  Telephone appointment
Should you need to cancel or reschedule your appointment, please contact their office at
 [phone number]

You have a follow-up appointment with [provider, including role]:

on [date] at [time] AM/PM

at [clinic or facility name]
Their clinic/facility is located at [clinic or facility address]

Your appointment will take place:
 In person  Virtual appointment  Telephone appointment
Should you need to cancel or reschedule your appointment, please contact their office at
 [phone number]

You have a follow-up appointment with [provider, including role]:

on [date] at [time] AM/PM

at [clinic or facility name]
Their clinic/facility is located at [clinic or facility address]

Your appointment will take place:
 In person  Virtual appointment  Telephone appointment
Should you need to cancel or reschedule your appointment, please contact their office at
 [phone number]

 Page | 15
Appendices
 APPENDIX H
QUICK REFERENCE GUIDE FOR REDUCING RISKS AND HARMS:
ASSESSMENT AND MANAGEMENT OF Ask what clients already know and what they would like to know so harm
CLIENTS WITH METHAMPHETAMINE reduction advice can be tailored, appropriate, and engaging.
CONCERNS Clients may be encouraged to:
 • Drink plenty of water and eat a balanced diet.
 • Brush and floss teeth regularly and chew sugar free gum, encourage
METHAMPHETAMINE clients to follow-up regularly with their dentist.
Methamphetamine is a strong stimulant that can be smoked, • Get adequate rest – encourage regular users to have regular non-using
injected, snorted or swallowed. Some common slang terms for days each week or plan a ‘crash’ period when they can rest and sleep
it include ‘ice’, ‘speed’ or ‘pint’. Methamphetamine causes the undisturbed for several days to ‘come down’.
brain to release a huge amount of certain chemical messengers,
which make people feel alert, confident, social and generally great. • Be clear about individual signs and symptoms of psychosis. If
They are also responsible for the “flight or fight” response. The psychotic symptoms are experienced, take a total break from
problem is that there are only so many of these messengers stored at using and seek professional help from the person’s Primary Care
any one time. Over time, neurotransmitters become depleted; leading Provider, local emergency department, or local mental health
to poor concentration, low mood, lethargy and fatigue, sleep disturbances service.
 • Call on friends or family who are stable
and lack of motivation. supports in the person’s life.
SHORT-TERM EFFECTS: • Plan for the week ahead and brainstorm
During Intoxication: sense of well-being or euphoria, energetic, extremely alternatives to using.
confident, sense of heightened awareness, talkative, fidgety, and dilated pupils. • Avoid driving when intoxicated or ‘coming
At Higher Doses: tremors, anxiety, sweating, palpitations (racing heart), dizziness, down’.
irritability, confusion, teeth grinding, jaw clenching, increased respiration, auditory, • Provide clients with a Naloxone Kit. Clients
visual or tactile illusions, paranoia and panic state, loss of behavioral control, or may be using multiple substances or their
aggression. methamphetamine may unknowingly contain
 opioids. If your practice area does not have
LONG-TERM EFFECTS: Naloxone Kits available, clients can obtain one
Weight loss, dehydration, extreme mood swings, depression, suicidal feelings, anxiety, for no charge at their local pharmacy.
paranoia, psychotic symptoms, cognitive changes including memory loss, difficulty
concentrating, impaired decision-making abilities, dental decay, skin infections, and increased
cardiac and stroke risk.
TREATMENT:
The evidence for pharmaceutical therapies to supplement methamphetamine addiction
treatment is not strong enough, nor consistent enough to be introduced INTOXICATION:
as a standard of practice. Remember that an intoxicated person has
 • Benzodiazepines or atypical antipsychotics, such as olanzapine, are useful impaired judgment and will probably view the
 in the short term for reducing acute psychotic symptoms and agitation interaction differently than you do.
 associated with methamphetamine use. There is a risk of dependence What to look for:
 and misuse associated with benzodiazepines so they should be used • Rapid, pressured speech or dissociated speech
 cautiously. • Repetitive movements
 • There is currently no strong evidence to support medications • Clenched jaw, teeth grinding (bruxism)
 specific to cravings or withdrawal symptoms for clients with • Suspiciousness or paranoia
 methamphetamine concerns. Treatment is highly individualized • Anger, irritability, hostility
 and tailored to the client’s symptoms. • Restlessness, agitation, pacing
 • The evidence for psychosocial and behavioral interventions • Impulsivity or recklessness
 for methamphetamine addiction treatment is mixed though • Sweatiness
 contingency management combined with cognitive • Large (dilated) pupils
 behaviour therapy may help with abstinence. RESPONDING TO INTOXICATION:
 • Attempt to steer an intoxicated person to an area that is less stimulating while
 ensuring the client and practitioner both have an easily accessible exit.
 • Maintain a calm, non-judgmental, respectful approach.
 • Listen and respond as promptly as possible to needs or requests. Do
ADAPTED FROM: not argue with the person and try not use “no” language. If you cannot
Jenner, L. & Lee, N. (2008). Treatment Approaches for provide what they are asking for, be clear about what you can provide
Users of Methamphetamine: A practical guide for frontline (e.g. I hear what you are saying, so let me see what I can do to help).
workers. Australian Government Department of Health & • Allow the person more personal space than usual.
Ageing, Canberra. • Use clear communication (short sentences, repetition, and ask for
WITH EXCERPTS FROM: clarification if needed).

Alberta Health Services. (2019). Managing
Methamphetamine Use. Edmonton, AB: Author.
 Page | 16
OVERDOSE:
 What to look for:
 • Hot, flushed, sweating
WITHDRAWAL: • Severe headache
Many methamphetamine users will experience what is • Chest pain
referred to as a ‘crash’ or a brief recovery period when they • Unsteady walking
stop using, which might last for a few days up to a few weeks
 • Muscle rigidity, tremors, spasms, fierce jerking
and is likely to include prolonged sleep, increased appetite,
 movements, seizures
some irritability and a general sense of feeling flat, anxious or out
of sorts. • Severe agitation or panic
 • Difficulty breathing
Clients may experience:
 • Altered mental state (e.g. confusion, disorientation)
 • A range of feelings from general dysphoria to significant clinical
 depression, anhedonia RESPONDING TO AN OVERDOSE:
 • Mood swings, anxiety • Call 911
 • Irritability or anger, agitation • Apply basic first aid principles while waiting for
 • Aches and pains emergency care to arrive
 • Sleep disturbance, lethargy, exhaustion, insomnia
 • Poor concentration and memory
 • Cravings to use methamphetamine
RESPONDING TO WITHDRAWAL:
 • Tell the person what to expect, including probable time course and common
 symptoms.
 • Determine what was and was not helpful during any previous withdrawals.
 • Recommend adequate diet, rest and fluid intake and prepare by having a
 supply of nutritious food/drink.
 • Schedule follow up visits to assess mood, sleep, and any other
 PSYCHOSIS
 symptoms and support the client to create a relapse prevention plan. Psychosis can be fleeting and last for hours, days or a couple
 of weeks. For a small number of clients it can be chronic.
 • Identify key social supports and educate the family/carers about
 Consultation with an addiction medicine specialist or psychiatrist
 withdrawal and what to expect.
 may be helpful to determine the best approach to care.
 • Refer to an addiction medicine specialist or psychiatrist,
 What to look for:
 especially if symptoms extend past 1-2 weeks, and recommend
 ongoing interventions such as counselling to prevent relapse. • Suspiciousness, hyper vigilance (constantly checking for
 threats)
 • Erratic behaviour (often related to overvalued or paranoid
 ideas, e.g. arguing with bystanders for no apparent reason,
 talking or shouting in response to “voices”)
 • Delusions (e.g. believing others have malicious intentions,
 or they are under surveillance)
 • Hallucinations (e.g. hearing voices, feeling of bugs crawling
 under the skin, etc.)
 • Illogical, disconnected or incoherent speech
 RESPONDING TO PSYCHOSIS:
 • Choose only one worker who will communicate with the person. Have another staff member present to
 observe or step in only if required (have a code word to call for assistance from the communicator to the
 observer).
 • Check for a history of violence or aggression.
 • Attempt to steer the person to an area that is less stimulating while ensuring both you and the client have an
 easily accessible exit.
 • Mirror body language signals from the person (e.g. sit with a person who is seated, walk with a person who is
 pacing, etc.) to show empathy.
 • Monitor and use appropriate eye contact and always appear confident.
 • Use a consistently even tone of voice, even if the person’s tone becomes hostile or aggressive.
 • Use the person’s name if known, or the communicator should introduce themself by name.
 • Carefully call the person’s attention to their immediate environment (e.g. “You’re in the hospital and you are
 completely safe now”).
 • Use careful, open ended questioning to determine the cause of the behaviour or the person’s needs and
 communicate your willingness to help.
 • Do not agree with or support the unusual beliefs, simply say “I can see that you’re scared,
 how can I help you?”.
 • Try not to use ‘no’ language, which may prompt further agitation, rather use
 statements like “This is what I can| do
 Page 17for you”.
RESOURCES
METHAMPHETAMINE/SUBSTANCE USE CULTURALLY APPROPRIATE CARE
Resources and Training: Resources and Training:
 • Management of Substance Use in Acute Care Settings • Multicultural Mental Health Resource Centre
 in Alberta: Guidance Document – Canadian Research https://multiculturalmentalhealth.ca/training/
 Initiative in Substance Misuse
 • Developmental Pathways of Addiction and Mental
 https://crismprairies.ca/management-of-substance-
 Health – Infusing Culture and Equity – Alberta Health
 use-in-acute-care-settings-in-alberta-guidance-
 Services (My Learning Link and PHC Learning Portal)
 document/
 • Concurrent Disorders Playlist – Alberta Health Services HARM REDUCTION
 https://www.albertahealthservices.ca/info/page14397. Resources and Training:
 aspx
 • Harm Reduction Guidelines – BC Centre for Disease
 • Addiction Care and Treatment Online Certificate – Control http://www.bccdc.ca/health-professionals/
 British Columbia Centre for Substance Use https:// clinical-resources/harm-reduction
 www.bccsu.ca/about-the-addiction-care-and-
 • Harm Reduction and Recovery in Primary Care – Alberta
 treatment-online-certificate/
 Health Services https://ahamms01.https.internapcdn.
 • Caring for Clients with Methamphetamine Concerns – net/ahamms01/Content/AHS_Website/modules/phc-
 Methamphetamine Client Transitions to Primary Care opiod-response-initiative/story_html5.html
 Project (My Learning Link and PHC Learning Portal)
 • Harm Reduction: Making a Difference in Practice –
TRAUMA INFORMED CARE Alberta Health Services https://ahamms01.https.
Resources and Training: internapcdn.net/ahamms01/Content/AHS_Website/
 modules/amh/amh-harm-reduction-difference-
 • Trauma Informed Care – Canadian Centre on Substance practice/story_html5.html
 Use and Addiction https://www.ccsa.ca/sites/default/
 files/2019-04/CCSA-Trauma-informed-Care-Toolkit-
 2014-en.pdf
 • Developmental Pathways of Addiction and Mental
 Health – Understanding ACEs and Being Trauma
 Informed – Alberta Health Services (My Learning Link
 and PHC Learning Portal)

 • Brain Story Certification – Alberta Family Wellness
 Initiative https://www.albertafamilywellness.org/
 training

MOTIVATIONAL INTERVIEWING
Resources and Training:
 • Motivational Interviewing Techniques – Facilitating
 behavior change in the general practice setting – McGill
 University https://www.mcgill.ca/familymed/files/
 familymed/motivational_counseling.pdf
 • Developmental Pathways of Addiction and Mental
 Health – Motivational Interviewing and Stages of
 Change – Alberta Health Services (My Learning Link and
 PHC Learning Portal)
Appendices

 APPENDIX I

 CHANGING
 The language we use has a direct and profound
 impact on those around us. The negative
 impacts of stigma can be reduced by changing

 HOW WE
 the language we use about substance use.

 TWO KEY PRINCIPLES INCLUDE:

 TALK ABOUT • Using neutral, medically accurate
 terminology when describing substance use

 SUBSTANCE
 • Using “people-first” language, that focuses
 first on the individual or individuals, not the
 action (e.g. “people who use drugs”)

 USE*
 It is also important to make sure that the
 language we use to talk about substance use is
 respectful and compassionate.

 TOPIC INSTEAD OF USE

 People who Addicts People who use drugs
 use drugs Junkies People with a substance use disorder
 Users People with lived/living experience
 Drug abusers People who occasionally use drugs
 Recreational drug user

 People who have Former drug addict People who have used drugs
 used drugs Referring to a person as People with lived/living experience
 being “clean” People in recovery

 Drug use Substance/drug abuse Substance/drug use
 Substance/drug misuse Substance use disorder/opioid
 use disorder
 Problematic [drug] use
 [Drug] dependence

 * This document was created in discussion with people with lived and living experience, through existing research and documentation from other
 organizations trying to address stigma. This is not an exhaustive list. Furthermore, as a result of the evolving discussion around the best language
 to use to accurately discuss substance use, this list will likely be revised.
 Cat.: HP5-132/2018E-PDF | ISSN: 978-0-660-27219-1 | Pub.: 180182

 https://www.canada.ca/content/dam/hc-sc/documents/services/publications/healthy-living/
 problematic-substance-use/substance-use-eng.pdf
 Page | 19
Appendices

 APPENDIX J

CARE CONSIDERATIONS FOR CLIENTS WITH METHAMPHETAMINE
CONCERNS IN PRIMARY CARE

The Role of Primary Care
Primary care providers are well positioned to provide meaningful, timely care to clients experiencing concerns
with methamphetamine use. Often there can be a long delay between when people start experiencing impacts
from their substance use to when they seek help. A primary care provider may be one of the few health
professionals that people using methamphetamine interact with so any opportunity to ask questions and engage
with a client about their substance use should be taken.

Through the development of an ongoing, trusting relationship, primary care providers are familiar with the life
circumstance of their clients, allowing them to offer advice and treatment which is tailored to the client’s specific
situation. Even if they are not ready to quit, primary care providers can help clients care for other aspects of their
health and offer harm reduction advice.

Primary care providers may feel pressured to deal with the client’s presenting issue first and discuss their
methamphetamine use at another time. However, clients who use methamphetamine may have little contact
with health services and engaging with them on this topic can set the stage for later change and help them avoid
future harms.

Post-Discharge from Hospitals or Detoxification/Recovery Centres
Clients with methamphetamine concerns who have been discharged from an emergency department, inpatient unit or
detoxification/recovery centre will likely benefit from additional support, such as team based care. Follow-up timeframe
recommendations may be included in the client’s discharge plan or summary and may vary based on the client’s specific
situation. If no timeframe has been specified, it is reasonable to follow-up with these clients within 24 hours to 2 weeks of
discharge from hospital-based care or 3-7 days within discharge from a detoxification/recovery centre.
Ways to Provide Support for Long-Term Management
 • Some clients may disclose methamphetamine use but have no intention of quitting – this can still be used as an
 opportunity to assess their health (e.g. viruses, infections, etc.).
 • Engage team members such as Behavioral Health Consultants, Nurses, or Social Workers to provide additional
 support for clients. Resources may vary depending on your Primary Care Network.
 • Discuss with clients whether they would like to be referred to an addiction treatment program or self-help group. A
 list of community resources is available at https://edmonton.cmha.ca/211-resource-lists/.
 • Before clients leave the clinic, ask them to commit to a follow-up appointment and make a booking for them before
 they go. If your clinic is able, set up a reminder call or text for their next appointment.
 • If appropriate, ask to include the client’s family in treatment plans and consider their point of view and experience of
 the situation.

 Page | 20
Appendices

 APPENDIX J - CON’T

Holistic Approaches to Care
These holistic approaches to care should be considered for all clients with methamphetamine concerns, regardless of their
specific situation or goals. They help to foster continued relationships and reduce stigma surrounding substance use.

Trauma Informed Care – This approach recognizes the need Motivational Interviewing – This approach strengthens an
to provide physical and emotional safety for clients with individual’s motivation for change and encourages movement
methamphetamine concerns, as well as choice and control toward their goals. It involves a collaborative process between
in treatment decisions. Understanding and considering the the client with methamphetamine concerns and their provider.
pervasive nature of trauma, trauma informed care promotes The basic skills of motivational interviewing include asking
environments of healing and recovery rather than practices and open-ended questions, making affirmations, and using reflection
services that may inadvertently re-traumatize individuals. It is and summarizing. Primary care providers can utilize these basic
beneficial for all staff, including non-clinicians, to receive training skills with more advanced interventions being utilized by mental
in trauma informed care. health practitioners.
For more information on Trauma Informed Care: For more information on Motivational Interviewing:
Courses: Courses:
 • Developmental Pathways of Addiction and Mental Health – • Developmental Pathways of Addiction and Mental Health –
 Understanding ACEs and Being Trauma Informed – Alberta Understanding ACEs and Being Trauma Informed – Alberta
 Health Services (My Learning Link and PHC Learning Portal) Health Services (My Learning Link and PHC Learning Portal)

Additional training and resources: Additional resources:
 • Crisis and Trauma Resource Institute - • Motivational Interviewing Techniques – Facilitating behavior
 https://ca.ctrinstitute.com/ change in the general practice setting – McGill University
 • Trauma Informed Care – Canadian Centre on Substance Use https://www.mcgill.ca/familymed/files/familymed/
 and Addiction https://www.ccsa.ca/trauma-informed-care- motivational_counseling.pdf
 essentials-series Harm Reduction - This approach recognizes that abstinence from
 • Brain Story Certification – Alberta Family Wellness Initiative methamphetamine is not always a client’s goal. It encompasses
 https://www.albertafamilywellness.org/training practices, programs, and policies that aim to reduce the risks
 and harm associated with substance use. Harm reduction is
Culturally Appropriate Care – This approach recognizes that about meeting people where they are and identifying the
cultural experiences can influence how clients express symptoms goals they wish to achieve based on their individual needs and
and receive information. They can also affect the client’s circumstances. It should be discussed with all clients regardless
preferred treatment options and the people involved in their of their goals around their substance use, especially due to high
care. A culturally appropriate care approach acknowledges the rates of relapse in recovery.
values, traditions, history, and family system of the individual to
provide the best care possible. For more information on Harm Reduction:
 Courses:
For more information on Culturally Appropriate Care: • Harm Reduction and Recovery in Primary Care –
Courses: Alberta Health Services https://ahamms01.https.
 • Developmental Pathways of Addiction and Mental Health – internapcdn.net/ahamms01/Content/AHS_Website/
 Understanding ACEs and Being Trauma Informed – Alberta modules/phc-opiod-response-initiative/story_html5.html
 Health Services (My Learning Link and PHC Learning Portal)
 • Harm Reduction: Making a Difference in Practice – Alberta
Additional training and resources: Health Services
 • Multicultural Mental Health Resource Centre https://ahamms01.https.internapcdn.net/ahamms01/
 https://multiculturalmentalhealth.ca/training/ Content/AHS_Website/modules/amh/amh-harm-reduction-
 difference-practice/story_html5.html
 Additional resources:
 • Harm Reduction Services – Alberta Health Services
 https://www.albertahealthservices.ca/info/Page15432.aspx
 • Harm Reduction Guidelines – BC Centre for Disease
 Control http://www.bccdc.ca/health-professionals/clinical-
 resources/harm-reduction

 Page | 21
Appendices

 APPENDIX K
TEAM BASED CARE FOR CLIENTS WITH METHAMPHETAMINE CONCERNS

Clients with methamphetamine concerns often have complex needs that can fall outside the realm
of medical treatment. Various primary care team members can support the client’s mental health,
socioeconomic, lifestyle, and pharmaceutical care. A team based care approach can help more
effectively address client’s needs.
Membership with a Primary Care Network (PCN) allows clients to access multiple providers
within a medical home. As each PCN may offer different programs and services, it is
important to connect with your PCN representative to inquire about which providers your
clinic has available for client care.

 How they can support clients with
 Position Role
 methamphetamine concerns
 Physician/Nurse • Provides diagnosis, treatment, and ongoing care • Screening for substance use concerns.
 Practitioner/Physician’s of illnesses and medical conditions. • Counselling and education on harm reduction
 Assistant • Addresses all health needs and develops a techniques.
 (Primary Care Provider) plan that may involve further testing; specialist • Referral to other roles within the PCN or
 referral; and medication; therapy; and diet or specialists as required.
 lifestyle changes.

 Behavioural Health • Works with clients and health care teams to • Develop plans to reduce or abstain from
 Consultant (BHC) support individuals who are experiencing substances and assist with other lifestyle
 mental health or addiction concerns, life stress, changes.
 motivational issues, or other concerns.

 * Some BHCs may also be
 • Provides brief interventions and can provide
 Registered Social Workers support with emotional or behavioral issues
 such as anger, anxiety, depression, stress, and
 bereavement.

 Social Worker • Provides guidance, information, advocacy, help, • Provide support with applying for financial and/
 counseling, and support when applying for and or health benefits.
 accessing a range of services relating to various • Provide information on food hampers and
 socioeconomic needs. community meals.
 • Support with finding emergency shelter or short
 term/permanent housing.
 • Provide information on where to apply for jobs
 and job placements.
 • Provide information on abuse, domestic violence
 and safety planning if client is a victim of abuse.
 • Provide informational resources on common
 legal issues.
 • Provide information on recreation programs,
 events and services.

 Page | 22
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