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Abstract
Wait times for methadone maintenance programs are associated with significant dropout rates. This puts the substance user at risk of continued illegal and high-risk behavior. We describe a unique model of daily dispensing opiates other than methadone to “bridge” clients awaiting methadone management. The Health and Harm Reduction Clinic is a community-based, primary care health clinic in Edmonton, Alberta, Canada, an urban city of 1 million. The team is comprised of a family physician, nurse practitioner, social/mental health worker and addictions counsellor. Descriptive data utilizing chart reviews from 2001 to 2005 are presented: one hundred four noninjection drug users and 86 injection drug users, with 43 of the latter being “bridged.” This team model, which includes opiate bridging to a methadone program, appears to provide a reasonable approach for community-based practices to offer quality care for substance-abusing patients. Further clarification of the impact on health outcomes and health service utilization is suggested.
Notes
1 Addiction treatment is a misnomer. Treatment can be briefly and usefully defined as a planned, goal directed change process, which is bounded (culture, place, time, etc.) and can be categorized into professional-based, tradition-based, mutual-help based (AA, NA, etc.) and self-help (“natural recovery”) models. There are no unique models or techniques used with substance users-of whatever types-which aren't also used with non-substance users. In the West, with the relatively new ideology of “harm reduction” and the even newer Quality of Life (QOL) treatment-driven model, there are now a new set of goals in addition to those derived from/associated with the older tradition of abstinence driven models. Editor's note