The rising rate of opioid-related deaths across Canada has been a public health emergency for over a decade. COVID-19 has exacerbated this crisis.
In Ontario, for example, the number of opioid-related deaths increased in the weeks after the state of emergency was declared on March 17, 2020. Overall, there was a 38.2% increase in opioid-related deaths in the first 15 weeks of the COVID-19 pandemic compared to the 15 weeks immediately prior.
“If we continued at that rate, there'd be a 50% increase in deaths,” says Dr. Kim Corace, vice president, innovation and transformation, and co-creator of the RAAM clinic in the substance use and concurrent disorders program at The Royal.
While there are numerous efforts underway to address the opioid crisis in Ontario, Dr. Melanie Willows, addiction medicine physician, clinical director with the substance use and concurrent disorders program at The Royal and co-creator of the RAAM clinic, says care for individuals with Opioid Use Disorder (OUD) has been fragmented. While wait times for comprehensive treatment are long and many people with OUD cycle repeatedly through emergency departments, there is hope.
New findings from The Royal’s Rapid Access Addiction Medicine (RAAM) Clinic indicate that this model of care makes a real difference for clients and families. RAAM fills a gap in care by providing treatment that is effective and easy to access.
It’s an urgent message that needs to get out, says Willows. “People need to know that effective treatments for opioid use are available, even now during the pandemic.”
RAAM is designed to provide rapid, low barrier access for anyone who needs help with substance use. First opened in May 2016, it expanded to address opioid use in February 2018. RAAM staff review treatment goals, provide individual counselling, mental health services, medication (if needed) for opioid and/or alcohol problems, and connect people with resources that best fit their needs.
In 2019, Corace – and partners from The Ottawa Hospital Research Institute and Public Health Ontario— received a grant from the Canadian Institute of Health Research (CIHR) to evaluate the effectiveness of the RAAM model – the first study of its kind.
Their findings demonstrate that RAAM clinics reduce the risk of overall mortality, hospitalizations, and visits to the emergency department, and provides decision-makers, practitioners, and communities, with the evidence urgently needed to collaboratively implement novel interventions to address the opioid crisis.
“Not only do RAAM clinics increase access to care, but they’re shown to be beneficial,” says Willows. “There are treatments that work.”
“As RAAM clinics grow (in number) it's important to understand their effectiveness,” says Corace. “This is a living example of the integration of research and care to promote innovation and improve patient outcomes. We want clients and families who are looking for services, to know there's hope.”