Invitation to participate in Opioid De-implementation Project- deadline March 14

Dear ED:

We are pleased to announce the launch of an initiative to help team-based primary care organizations to respond to Ontario’s opioid crisis. Our objective with this Opioid De-implementation project is to work with teams to make it easier to identify and replace low-value clinical practices in opioid prescribing with high-value clinical practices. The first thing we will do is work with you to decide on the right place to start, based on your team’s readiness to take action on opioid management. To that end, we need you to complete this Readiness Assessment Survey and return it to CAMH by March 14, 2018.

Once the survey is completed, the project team at CAMH will work with you to rapidly launch the initiative at your organization, starting with interventions that make the most sense to your team. Some teams will therefore proceed directly into the initiative while others will work together with the CAMH project team to bring up their readiness and capacity for the full implementation. Sites will therefore go live with the initiative on a staggered schedule, starting in March 2018.

Through the Opioid De-implementation initiative, you will also receive training and support for clinicians in upgrading knowledge and practice confidence in opioid prescribing/de-prescribing. Finally, the project will also build shared-care pathways between primary care sites and ministry-funded community addictions treatment agencies where possible. Together with you, we hope to co-develop a model for multi-sectoral collaboration to provide comprehensive system-level support to patients who are taking opioids.

As you know, action on opioid management is urgently needed in our province to help save lives of Ontarians. Canada is the second-largest per capita consumer of prescription opioids in the world. In Canada, the use of prescription opioids is highest in Ontario. While opioids are a key intervention for pain management, they also carry significant risks of addiction, overdose and death from overdose. There has been a 285% increase in opioid-related deaths from 1991 to 2015. These now far exceed the number of deaths from motor vehicle accidents. According to 2015 statistics, 4 out of 5 opioid-related deaths were accidental, and thus avoidable. We are called upon to rise to this challenge and find feasible and sustainable solutions.

This Opioid De-implementation initiative is funded by the Ministry of Health and Long-Term Care (MOHLTC) and led by the Centre for Addiction and Mental Health (CAMH) in partnership with the Association of Family Health Teams of Ontario (AFHTO), and in collaboration with Health Quality Ontario (HQO). We are aligning this initiative with the broader work in the provincial opioid strategy for supporting opioid prescribing and pain management.

See below for some key points you might find useful in discussing this initiative with your team. More details this Opioid De-Implementation Initiative and the immediate benefits it has to offer your organization can be found in this 1-page brochure.

If you have any questions regarding this initiative you may contact Sarwar Hussain, Director of Innovation, Operations & Strategy, CAMH at (416) 535-8501 ext.77417; sarwar.hussain@camh.ca or Elise Tanzini, Research Coordinator, CAMH at (416) 535-8501 ext.77437; elise.tanzini@camh.ca

Yours sincerely,

Key points for discussion among teams

• MOHLTC recognize success of the STOP smoking program to help teams move forward from where they are on the continuum of change and is therefore supporting the same ground-up approach to address the opioid crisis. MOHLTC recognizes that the system depends on excellence in primary care and therefore is investing in it to help the system respond to the opioid crisis.
• MOHLTC recognizes that primary care providers are best placed to really make a difference through their relationships with patients and therefore wants to invest in those relationships to get better outcomes for the system in general and specifically regarding opioid management in this case.