Patients and doctors work together to improve care for substance users

August 23, 2018
Cindy MacDougall

For many people, the family doctor’s office is a place of care, safety and help in times of illness, injury or other troubles.

But for people who use substances such as drugs and alcohol, the doctor’s office can be a place where they perceive judgment or shame.

“Someone who uses substances brings so much personal history into an interaction with a physician,” says Prof. Elizabeth Hartney, program head of the Master of Arts in Leadership—Health specialization at Royal Roads University. “They are often bringing a history of trauma that has led to their substance use. So it makes all the difference when physicians and the health system support the person and compassionately recognize their substance use is a way of trying to manage their own pain.”

Hartney, a registered psychologist and an expert on mental health and substance use policy in health care, is working with a broad team to improve primary health care for substance users. Master of Arts in Leadership (Health) student Bryn Meadows is also working on the project as part of her leadership project.

The team recently brought together patients, doctors and health system partners such as Island Health and the Ministry of Health for a two-day workshop to explore the best practices for family doctors who care for this group of patients—with the patients acting as experts.

The workshop is part of the work funded by a Convening and Collaborating (C2) grant by the Michael Smith Foundation for Health Research (MSFHR) to bring together people within the health system who don’t typically collaborate on the issue of services for people who use substances.

Patients and doctors switched typical roles, with the patients taking questions from doctors and the entire group brainstorming to improve the quality of care offered to people who use substances.

“We are working together towards making the health care system a support system, not as a place where patients may experience further shaming and humiliation, but a place where they get the help they need to turn their lives around and feel like someone is on their side.”

Hartney describes it as “a powerful emotional experience.”

“It wasn’t just all bad things that had happened. Patients also talked about what physicians and other health system partners did that helped them go from a place of powerlessness with their addiction to feeling like they were supported and there was hope for the future."

The team will share the set of best practices developed at the workshop with the Victoria Division of Family Practice, the Ministry of Health and other parts of the health care system as a learning resource not only for doctors but also those who create health care policy and procedures.

“We’re in the midst of an opioid epidemic,” Hartney says. “It’s vital we get these best practices out there not only in BC but across North America.”