McGill.CA / McGill Addiction Research Group / Current Projects

Substance Abuse Treatment: Tools for the Front Line Practitioner

CIHR Team in Substance Abuse Treatment - Treating Substance Dependence and Mental Illness: Tools for the Front Line Practitioner

(Phase 1: data collection complete, data analysis and manuscript preparation in progress;  Phase 2: in progress)

The objective of this program of research is to accelerate the translation of treatment strategies created by science into effective practices. The research will examine the process of implementation of an evidence-based program of treatment for substance dependence into three primary care clinics in Montreal, administered by a Health and Social Services Centre (Centre de Santé et de Services Sociaux; CSSS), and directly measure program effectiveness as determined by changes in health care service delivery, sustainability and outcomes for patients. During the process of program implementation, the Team will utilize an integrated knowledge translation (iKT) strategy to build collaborative mechanisms for knowledge exchange between researchers, addiction specialists and frontline practitioners (guided by the principles of participatory-action research), and directly examine the process of knowledge uptake and barriers to transfer using both qualitative and quantitative methodologies. Evaluation will involve multiple measures, time points and domains, taken from the perspective of multiple stakeholders. Patient outcomes will be determined by a multivariate index that includes retention in treatment, changes in the amount and frequency of drug/alcohol consumption, reduction in the severity of addiction, duration of continuous abstinence, reductions in psychological distress (depression, anxiety), number of visits to emergency services, number of hospitalizations, as well as improvements in psychosocial functioning and quality of life. Phase 1 of the project had been completed and involved a needs assessment to inform the development of training materials, methods and delivery, clinician training via the implementation of an addictions program coordinator, establishing a portrait of clinical practice and exploring current organizational readiness to change.

Phase 2 is a qualitative expansion of phase 1, exploring the implementation process and development of frontline services for substance abuse at multiple CSSS throughout Quebec. This research project was concurrent with policies from the Quebec Ministry of Health and Social Services (MSSS) mandating CSSS to provide screening and early intervention for substance abuse (and gambling). Organically the project expanded to examining the facilitators and barriers of these policies. Each of the 94 CSSS in Quebec was invited to participate in phase 2, followed by a purposive sampling of 21 CSSS.  To date, 45 participants have been interviewed including clinicians, management and directors involved in the development and implementation of services for substance abuse.

  

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