Reducing Overdose And Relapse: Concurrent Attention to Neuropsychiatric Ailments and Drug Addiction
ROAR CANADA is a 5-year research study funded by Health Canada, focused on people being treated for severe concurrent disorders (SCD). Concurrent disorders are mental illness and substance use disorder that happen at the same time. Often, people with SCD only receive treatment for one of their concerns at a time. Currently, there are only a few places that provide integrated comprehensive treatment and recovery for SCD.
This study focuses on 2 treatment centres: 1) The Burnaby Centre for Mental Health and Addiction (BCMHA), a tertiary inpatient centre where people with SCD stay for long-term treatment; and 2) the M1 ward of St. Joseph’s Healthcare Hamilton, which is an acute inpatient ward where people with SCD stay to be stabilized and receive care before transitioning to other treatments. By following clients from BCMHA and M1, we will learn more about people with SCD and about treatment outcomes.
We are interviewing clients of M1 and BCMHA 4 times: a baseline interview close to when they are admitted, a second interview at discharge, and 2 more interviews at 1 month after discharge and 6 months after discharge. Information from interviews will be complemented by chart reviews and administrative data from medical and legal services.
With 1,500 planned participants, we are assembling the largest-ever sample of people with severe concurrent disorders. This population is difficult to reach, and often left out of research studies—regularly excluded from mental health studies because of their substance use or from addiction studies because of their mental disorder diagnoses.
Participants are considered difficult to treat: they have been through other mental health treatment and other substance use treatment without persistent improvement. By collecting data before, during, and after their stay, we can learn what treatment-as-usual looks like, how M1 and BCMHA differ, and how these new integrated treatments change outcomes. In particular, our goal is to learn about overdose and relapse after discharge, and how to prevent them.
The study will provide much-needed information on this population and will allow us to explore subgroups, looking at differences based on things like sex, age, and whether participants live in urban or rural areas. We will also be able to look at factors that might improve or inhibit recovery, like participants’ cognitive skills or their social support structure. We will be able to look at a variety of outcomes such as emergency department utilization, continuity of care, continued use of medication, victimization, police contacts, etc.