Ginette Poulin - Academia.edu (original) (raw)
Papers by Ginette Poulin
CMAJ. Canadian Medical Association journal, Mar 10, 2024
Canadian Medical Association Journal
Substance Abuse Treatment, Prevention, and Policy
Background People living in rural and remote communities in Canada are often disproportionately i... more Background People living in rural and remote communities in Canada are often disproportionately impacted by opioid use disorder. When compared to urban centres, rural and remote populations face additional barriers to treatment, including geographical distance as well as chronic shortages of health care professionals. This integrative review of the literature was conducted to explore the facilitators and barriers of OAT in rural and remote Canadian communities. Methods A search of the literature identified relevant studies published between 2001 and 2021. Results The search strategy yielded 26 scholarly peer-reviewed publications, which explored specific barriers and facilitators to rural and remote OAT in Canada, along with two reports and one fact sheet from the grey literature. Most of the scholarly articles were descriptive studies (n = 14) or commentaries (n = 9); there were only three intervention studies. Facilitators and barriers to OAT programs were organized into six theme...
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, Jan 5, 2018
O pioid use disorder is one of the most challenging forms of addiction facing the Canadian health... more O pioid use disorder is one of the most challenging forms of addiction facing the Canadian health care system, and a major contributor to the marked rises in opioidrelated morbidity and death that Canada has been seeing in recent years. The evolving landscape of nonmedical opioid use has become increasingly dominated by prescription opioids diverted from the medical system and, more recently, by highly potent, illicitly manufactured synthetic opioids (e.g., fentanyl and its analogues, including carfentanil). 1 The mean national rate of hospital admissions related to opioid poisonings increased from 9 hospital admissions per day in 2007/08 to more than 13 admissions per day in 2014/15. 2 A corresponding rise in injection of prescription opioids has been observed among people who inject drugs in Canada, 3,4 and has been associated with an increased risk of hepatitis C and HIV infections. 5-7 For 2016, the mean rate of apparent opioid-related overdose deaths has reached 7.9 per 100 000 population (i.e., corresponding to a total of 2861 fatalities), with the highest death rates reported for western Canada. 8 This upsurge in opioid-related harms, including overdose deaths, 2-6,8,9 underscores the critical need for coordinated, evidence-based approaches to prevention, treatment and harm reduction to address this national public health emergency. In most Canadian jurisdictions, poor geographic coverage and availability of evidence-based treatments for substance use disorders has limited the therapeutic options for individuals with opioid use disorder. 10 Further, even in settings where multiple treatment options are offered, detailed clinical guidance articulating their optimal use for varying presentations of opioid use disorder is lacking. Therefore, this guideline is intended to promote the use of evidence-based interventions for treatment of opioid use disorder across the addiction care continuum in Canada. Scope This guideline was developed to provide Canadian health professionals with an educational tool and clinical practice recommendations for the treatment of opioid use disorder. These recommendations are primarily relevant for the clinical management of this disorder in adults, including young adults.
CMAJ. Canadian Medical Association journal, Mar 10, 2024
Canadian Medical Association Journal
Substance Abuse Treatment, Prevention, and Policy
Background People living in rural and remote communities in Canada are often disproportionately i... more Background People living in rural and remote communities in Canada are often disproportionately impacted by opioid use disorder. When compared to urban centres, rural and remote populations face additional barriers to treatment, including geographical distance as well as chronic shortages of health care professionals. This integrative review of the literature was conducted to explore the facilitators and barriers of OAT in rural and remote Canadian communities. Methods A search of the literature identified relevant studies published between 2001 and 2021. Results The search strategy yielded 26 scholarly peer-reviewed publications, which explored specific barriers and facilitators to rural and remote OAT in Canada, along with two reports and one fact sheet from the grey literature. Most of the scholarly articles were descriptive studies (n = 14) or commentaries (n = 9); there were only three intervention studies. Facilitators and barriers to OAT programs were organized into six theme...
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, Jan 5, 2018
O pioid use disorder is one of the most challenging forms of addiction facing the Canadian health... more O pioid use disorder is one of the most challenging forms of addiction facing the Canadian health care system, and a major contributor to the marked rises in opioidrelated morbidity and death that Canada has been seeing in recent years. The evolving landscape of nonmedical opioid use has become increasingly dominated by prescription opioids diverted from the medical system and, more recently, by highly potent, illicitly manufactured synthetic opioids (e.g., fentanyl and its analogues, including carfentanil). 1 The mean national rate of hospital admissions related to opioid poisonings increased from 9 hospital admissions per day in 2007/08 to more than 13 admissions per day in 2014/15. 2 A corresponding rise in injection of prescription opioids has been observed among people who inject drugs in Canada, 3,4 and has been associated with an increased risk of hepatitis C and HIV infections. 5-7 For 2016, the mean rate of apparent opioid-related overdose deaths has reached 7.9 per 100 000 population (i.e., corresponding to a total of 2861 fatalities), with the highest death rates reported for western Canada. 8 This upsurge in opioid-related harms, including overdose deaths, 2-6,8,9 underscores the critical need for coordinated, evidence-based approaches to prevention, treatment and harm reduction to address this national public health emergency. In most Canadian jurisdictions, poor geographic coverage and availability of evidence-based treatments for substance use disorders has limited the therapeutic options for individuals with opioid use disorder. 10 Further, even in settings where multiple treatment options are offered, detailed clinical guidance articulating their optimal use for varying presentations of opioid use disorder is lacking. Therefore, this guideline is intended to promote the use of evidence-based interventions for treatment of opioid use disorder across the addiction care continuum in Canada. Scope This guideline was developed to provide Canadian health professionals with an educational tool and clinical practice recommendations for the treatment of opioid use disorder. These recommendations are primarily relevant for the clinical management of this disorder in adults, including young adults.