Optimal Management of Inpatients with Substance Use Disorders

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2-Part Series: Wed March 7 2018 and Wed April 11 2018 5:00 9:00 PM LOCATION: Guelph General Hospital Auditorium 115 Delhi St. Guelph, Ontario TARGET AUDIENCE: Hospitalists Internists - Intensivists ED Physicians - Psychiatrists - Nurse Practitioners Physician Assistants Nurses - Medical Students and Residents EDUCATIONAL OBJECTIVES: ü Understand the powerful and negative perceptions commonly associated with people who have a substance use disorder (stigma) ü Apply principles of self-awareness, professionalism, communication and ethics to provide excellent medical care to patients admitted to hospital and concurrent substance use disorders ü Collaborate with in-hospital and community partners aimed at supporting inpatients who are open to receiving assistance with their substance use disorder ü Identify, evaluate and provide medical care for inpatients at risk for or undergoing substance use withdrawal CME ACCREDITATION: McMaster University, Continuing Health Sciences Education Program (CHSE) is fully accredited by the Committee on Accreditation of Continuing Medical Education (CACME) to provide CFPC Mainpro+ and RCPSC Maintenance of Certification (MOC) study credits for Continuing Medical Education. This Group Learning program meets the certification criteria of the College of Family Physicians of Canada and has been certified by the McMaster University, Continuing Health Sciences Program for up to 6.0 Mainpro+ credits This activity is an Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification program of The Royal College of Physicians and Surgeons of Canada and approved by McMaster University, Continuing Health Sciences Education Program for up to 6.0 MOC Section 1 hours. Through an agreement between the Royal College of Physicians and Surgeons of Canada and the American Medical Association, physicians may convert Royal College MOC credits to AMA PRA Category 1 Credits. Information on the process to convert Royal College MOC credit to AMA credit can be found at www.ama-assn.org/go/internationalcme. REGISTRATION: ONLINE: http://www.fhs.mcmaster.ca/conted/calendar.html BY PHONE: Call 905 525-9140 ext. 22671 (Visa, MasterCard or AMEX are accepted) FEES: Physicians NP PA Nurses 2 Days (March 7 and April 11) $100.00 March 7 only $50.00 April 11 only $50.00 Students/Residents 2 Days (March 7 and April 11) $50.00 March 7 only $25.00 April 11 only $25.00

Wednesday March 7, 2018 Note: 25% of the time will be allotted for Question and Answer or Panel Discussion Date/Time Topic Speakers 5:00pm Buffet Dinner Meet and Greet All 6:00pm Welcome and Introductions Dr. M. Doré and C. Robinson 6:10pm Perceptions and Professionalism: Reducing Stigma Panel Discussion 6:45pm 7:15pm 8:15pm Substance Use Disorder in the Community Identification and Treatment of Inpatients with Opioid Use Disorder Supporting a Road to Recovery for Inpatients with Substance Use Disorders Dr. M. Doré - Moderator Patient/peer Helen Martini - GGH Patient Relations, Quality and Patient Safety Team H. Watson Emergency Mental Health and Addiction Services (EMHAS)* Dr. Y. Chorny RAAC Guelph Police Services Dr. A. Sharma Dr. M. Parent Guelph General Hospital H. Watson EMHAS* A. Crowder WGDS** Local Community Resources 9:15-9:30 Conclusion and Evaluation Wednesday April 11, 2018 Note: 25% of the time will be allotted for Question and Answer or Panel Discussion 5:00pm Buffet Dinner All Meet and Greet 6:00pm Common Infections in Dr. J. Murdoch Guelph General Hospital Inpatients with Substance Use Disorders 6:45pm Identification and Treatment of Alcohol and Benzodiazepine Dr. R. Abd Halim 7:45pm Withdrawal Harm Reduction: Compassionate Care Of Persons with Substance Use Disorders Dr. S. Koivu London Health Sciences Centre M. Cruickshank EMHAS* 9:15-9:30 Conclusion and Evaluation * Emergency Mental Health and Addiction Services (GGH and Homewood) ** Wellington Guelph Drug Strategy

Specific Learning Objectives for Wednesday March 7, 2018 Perceptions and Professionalism: Reducing Stigma (Panel) Understand factors that generate, perpetuate and sustain stigma Gain a better understanding of the negative effects of stigma and stereotypes on people with substance use disorders Promoting theories about addictions to allow for the reinforcement of research-based principles to end stigma Examine ways in which access to and provision of services can be affected Mechanisms and types of stigma prevention approaches Establish and maintain a therapeutic alliance with inpatients with substance use disorder Substance Use Disorder in the Community (Guelph Police Officers) Recognize local and regional trends of illicit drug use in the community To learn about various illegal drugs in the community To understand the concerns of law enforcement in caring for individuals of substance-related disorders Identification and Treatment of Inpatients with Opioid Use Disorder (Dr. A Sharma and Dr. M Parent) Identify inpatients with possible opioid dependence Differentiate abstinence based treatment and withdrawal management from methadone and buprenorphine maintenance treatment Obtain a comprehensive pain, opioid use and other drug use history in patients with opioid dependence Obtain a psychosocial history screening for mental health issues, assess functional status and differentiate acute from chronic pain Recognize, assess severity and manage opioid withdrawal A review of stages of changes and basic motivational interviewing techniques to help engage a patient in long-term addiction treatment Collaborate with inpatient addiction team to coordinate a discharge plan that is patient appropriate and links inpatient with community services.

Supporting a Road to Recovery for Inpatients with Substance Use Disorders (EMHAS / Community Resources) Communicate effectively with inpatients with substance use disorder Help inpatients with substance use disorder begin to engage in long-term addiction treatment Collaborate with mental health and addiction services within the hospital and in the community Collaborate with inpatient addiction team to coordinate a discharge plan that is patient appropriate and links inpatient with community services, including appropriate referrals for medical conditions. Specific Learning Objectives for Wednesday April 11, 2018 Common Infections in Inpatients with Substance Use Disorders (Dr. J Murdoch) Identify and manage common infections in patients with substance use disorder Coordinate with the multidisciplinary team for an effective and safe plan for discharge and follow-up Identification and Treatment of Alcohol Withdrawal (Dr. R Halim) Screen and identify inpatients at risk for acute withdrawal from alcohol An overview of complications resulting from severe alcohol withdrawal and management Assess severity of alcohol withdrawal including factors associated with severe alcohol withdrawal Develop an evidence-based standardized approach for medical management of acute alcohol withdrawal Help inpatients with substance use disorder begin to engage in long-term addiction treatment Literature review of the CIWA and various other monitoring instruments Discussion on the pharmacological and psychological interventions available Update on Treatment of Benzodiazepine Withdrawal (Dr. R Halim) Recognize, assess severity and manage benzodiazepine withdrawal Review alternative strategies in treating benzodiazepine withdrawal Provide an update about new pharmacological interventions available to manage benzodiazepine withdrawal

Harm Reduction: Compassionate Care Of Persons with Substance Use Disorders (Dr. S Koivu, EMHAS) Manage inpatient medical issues during hospitalization of a person with active substance use disorder Develop a multidisciplinary holistic approach to risk reduction and safety Demonstrate practical strategies that will assist in promoting safety, reducing risk while maintaining patient dignity and respect This program has received an educational grant or in-kind support from the following: Guelph General Hospital Wellington Guelph Drug Strategy Indivior SMALL PRINT CANCELLATION POLICY: The University reserves the right to cancel a course due to insufficient registration or any circumstances that are beyond our control. Cancellations received before February 21, 2018 will be refunded less a 25% administrative fee. No refunds will be issued for cancellations received after this date. LIABILITY: Continuing Health Sciences Education (CHSE) hereby assumes no liability for any claims, personal injury, or damage: To any individual attending this activity. That may result from the use of technologies, program, products and/or services at this activity. That may arise out of, or during this activity. CONFIRMATION OF REGISTRATION: A written acknowledgment of your registration will be sent prior to the activity should you provide CHSE with your email address. Receipts will be provided in your registrant package upon arrival at the activity. Your registration is not complete unless a confirmation is received. If you have not received a confirmation within 7 days of registration, please contact the CHSE office. ACTIVITY PACKAGE: As the registrant your activity package includes buffet dinner and nutritional breaks. DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST: In keeping with accreditation guidelines, McMaster University; Continuing Health Sciences Education requires all speakers and planning committee members participating in this event to disclose any involvement with industry or other organizations that may potentially influence the presentation of the educational materials or program being offered. Disclosure must be done verbally and using a slide prior to the speaker s presentation. PHOTOGRAPHY: Candid photos will be taken at the event. Your registration implies your permission for these photos to be used for promotional material. Individuals in photographs will not be identified. FREEDOM OF INFORMATION AND PROTECTION OF PRIVACY ACT: The information on this form is collected under the authority of the McMaster University Act, 1976. The information will be used for administrative purposes, including: your registration in the course; preparation of course materials for your use and to notify you of other courses or pertinent information. Financial information will be used to process applicable fees and will be retained for future reference. This information is protected and is being collected pursuant to section 39(2) and section 42 of the Freedom of Information and Protection of Privacy Act of Ontario (RSO 1990). Questions regarding the collection or use of this personal information should be directed to the University Secretary, Gilmour Hall, Room 210 McMaster University

PLANNING COMMITTEE Meeting Chair: Marcel Doré MDCM MCFP FHM Hospitalist Guelph General Hospital Assistant Clinical Professor Department of Family Medicine McMaster University Meeting Organizer: Craig Robinson BHAdm, RSSW Planning Committee Coordinator Clinical Coordinator Regional Services Other Planning Committee Members: Madison Cruickshank BA, RP. Addictions Counselor EMHAS, Rasyidah Halim MD FRCPC, Psychiatrist for the Emergency and Consultation- Liaison Services Medical Director, Emergency Mental Health and Addictions Services (EMHAS) Assistant Clinical Professor (Adjunct) for Department of Psychiatry and Behavioural Neurosciences, McMaster University Melanie Iancovich, RN, CPMHN(C) Program Manager/Patient Care Coordinator Emergency Mental Health and Addiction Services (EMHAS) Guelph General Hospital/ Heidi Letham, RN, BScN, CPMHN(C) Clinical Director of Operations, Regional Services Abhinav Sharma, MD Assistant Clinical Professor Department of Psychiatry and Behavioral Neurosciences McMaster University Diplomate of the American Board of Psychiatry and Neurology Trillium Medical Director Consultant to the Emergency Mental Health and Addiction Services Heather Watson, BASc., MSW(c) Addiction Counselor EMHAS.