Clinical Care Guidance

I have had the opportunity to contribute to a number of clinical care guidelines, tools and resources to support clinicians in delivering evidence-based care. I include a couple of specific examples below, along with links to the final documents I’ve authored, reviewed or collaborated on.

Provincial Guideline for the Clinical Management of High-Risk Drinking and Alcohol Use Disorder – Pregnancy Supplement

In my role as Interim Clinical Director at the BC Centre on Substance Use and in collaboration with Perinatal Services BC, I provided guidance and leadership to our team of medical writers to write this guideline supplement, based on best available evidence.

  • I supported stewarding the committee and external review process and worked with government stakeholders regarding its endorsement and release in spring 2021.

  • This supplement is unique in that it focuses on the clinical management of pregnant individuals who may continue to engage in high-risk drinking during pregnancy and those with alcohol use disorder (AUD), and offers a review of the full range of treatment options, continuing care and postpartum considerations.

The final publication can be found here

Support for the Provincial Response to Dual Public Health Emergencies in BC: the Ongoing Overdose Crisis and COVID-19

In my role as Interim Clinical Director at the BC Centre on Substance Use, I led our provincial response to the dual public health emergencies in 2020 and 2021.

Stakeholder Engagement

This included working with my large and varied team as well as clinical and operational regional addiction leaders, government stakeholders in the Ministry of Health and Ministry of Mental Health and Addictions, individuals and family members of individuals with lived and living experience of substance use and the office of the Public Health Officer.

Supporting Knowledge Translation

In collaboration with the aforementioned stakeholders, I provided leadership in the development of a variety of clinical guidance documents and resources.

  • These resources provided readily available, easy to understand information about new Health Canada Controlled Drugs and Substances Act exemptions that impacted prescribers and pharmacists in the context of the pandemic.

  • These resources also provided guidance on how to support people to stay on prescribed treatments (i.e. opioid agonist treatments) for those with daily witnessed medications who were required to quarantine or self-isolate.

  • We also developed specific guidance to support people engaging in high-risk drinking or those with alcohol use disorder, in the context of the pandemic, who were likely to go into withdrawal if supply chains were disrupted or patients were no longer able to access liquor stores.

New ‘Risk Mitigation’ Clinical Guidance

In addition, our team was instrumental in developing first-of-its-kind guidance for prescribers to provide non-traditional prescription medications (i.e. safe supply) to individuals with active substance use who were at risk of COVID-19 as well as at high risk of withdrawal, overdose, or other harms related to drug use.

In my role, I worked closely with a variety of stakeholders, including addiction medicine clinicians, people with lived and living experience of substance use, government, and the office of the public health officer to develop this interim guidance document and ensure feedback and perspectives of these stakeholders was reflected in the final version. I also provided leadership to my team in developing a number of associated resources to support implementation. This document is currently being updated to reflect lessons learned in the first year of implementation.

Risk Mitigation in the Context of Dual Public Health Emergencies, plus associated bulletins, FAQs, webinars and more can be found here.

Operational Guidance for the Rapid Scale-Up of Managed Alcohol Programs in the Context of COVID-19

In collaboration with the Canadian Institute for Substance Use Research (CISUR), my team led the development of operational guidance for regional health authorities and other organizations interested in rapidly developing or scaling up managed alcohol services, in the context of COVID-19.

  • I provided guidance and support to my staff on work planning, logistics and problem solving

  • I provided review and editing of successive drafts of the document, incorporating needs expressed by stakeholders who anticipated using this document on release

  • I stewarded a number of stakeholder relationships – with our collaborators at CISUR, Ministry of Mental Health and Addictions, Ministry of Health, regional health authority mental health and substance use operational leaders and other invested health care providers and community organizations. 

Operational Guidance for Implementation of Managed Alcohol for Vulnerable Populations can be found here.