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The Forensic Opioid Use Disorder Initiative: One patient’s story of recovery

​The Forensic Opioid Use Disorder (OUD) Initiative is part of BC Mental Health and Substance Use Services' broader provincial strategy to address the opioid overdose crisis in B.C.
Earlier this year, the Ministry of Mental Health and Addictions granted funding to BC Mental Health and Substance Use Services for the Forensic Psychiatric Services (FPS) Regional Clinics and Correctional Health Services.
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The Forensics teams target these funds to enhance services for clients with substance use and concurrent disorders who are being seen in the community, regional clinics. Enhanced services include additional substance use training for front line staff and phsyciains and the addition of new staff, including concurrent disorder counsellors, outreach workers, opioid agonist therapy (OAT) physicians, and medical office assistants for each of the six teams across the province. The initiative has also involved providing access to eight new residential substance use treatment beds, operated by a contracted community service provider.

"We've introduced a new scope of service," said Kim Korf-Uzan, who is the project director coordinating the roll-out of the project. "We're not changing who we serve, but what we offer. Previously, when clients had substance use challenges, our clinicians worked with our partners in the community, however, with the addition of the new counsellors, we are able to provide a seamless connection to care within the clinics. Now, the regional Forensic Psychiatric Services clinics are more of a one-stop shop, taking into account that many of our clients are experiencing both mental health and substance use challenges."

Getting help throughout the recovery process

With the implementation of the OUD Initiative, clients like Tim* are able to get the help they need—before and after treatment, as well as during.

A Vancouver Island resident, Tim was offered a place in a residential substance use treatment program. He entered the 90-day program at the beginning this summer. With the OUD initiative in place, he was able to access a bed and receive counselling.

Prior to being referred to Forensic Psychiatric Services for treatment, he had experienced a relapse. He told this to his forensic community and liaison nurse, and psychiatrist Dr. Deanne Breitman at Victoria Forensic Psychiatric Services. "They took it really seriously," he says. "They really pushed for me to get in. About three weeks after that, I got in.

"My substance use had really taken its toll and I'd wanted to make changes for a number of years but with not much success," he says. "It's kind of hard to do on your own. The difference is, now I was able to look at the stuff that was underneath addiction, and work on those challenges. The whole way I was thinking and acting in my life, to just make progress with those things and with past traumas."

Treatment allowed him to see past identifying himself with his mistakes. "If you decided the negative aspects of your life are what you are, it's extremely hard to change your ways," he says.

"How is anyone supposed to move on from that if they've got that drilled into their head, that that's who they are, and they'll never be any different?"

Another effective part of treatment involved looking at the reasons he used drugs and alcohol to begin with.

"For me, fear was running the whole show. Everything I did, every action I took, was based in fear in one way or another. What I trained to do now is identify the fear, take a deep breath, and then trace that fear back to its origin.

"And I can say, 'Okay, that makes sense. Now I have some perspective. Now I'm not trapped inside this fear, and I'm looking at it from the outside.' Then I can do what I need to do to get through that, instead of going out and having a drink of alcohol."

Helping clients after treatment

Hearing from others in treatment was also helpful.

"There were no secrets," he says. "There was a lot of truth, a lot of courage. People who had never opened up, who had never talked about their stuff, who had just got out of jail or whatever and were really closed to it, after a week or so they started to engage. It was great to see people making all this progress."

He is still in touch with "at least a dozen" of his fellow group treatment members and is part of a home recovery group. "The opposite of addiction is connection. Staying connected as much as you can is definitely the way. It's not a nice path to tread by yourself."

As part of the OUD funding, clients are able to access a forensic outreach worker, who assists clients in getting to and from appointments, medical or otherwise, and provides one-to-one support and advice from others who have undergone treatment and recovery. They also have access to an addiction medicine physician if required.

Tim hasn't had to access the outreach services yet. "I'm pretty active with my recovery stuff already as far as seeing counsellors and doing group," he says. "But it's definitely something I intend to do in the near future. And it's probably just going to be a call to say 'Hello, everything's going well.' It's great to know that that resource is there."

*We have used an alias to protect anonymity so Tim can share the valuable impact the OUD funding has had directly on his quality of life and journey of recovery.

SOURCE: The Forensic Opioid Use Disorder Initiative: One patient’s story of recovery ( )
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