Episodios
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In this episode, journalist David P. Ball and outreach primary care physician Dr. Terri Aldred discuss the importance of culturally safe and trauma informed substance use care for Indigenous communities. Dr. Aldred shares how her lived experience informs her medical practice, caring for Indigenous Peoples experiencing challenges rooted in colonialism, systemic racism, and health inequities. David and Dr. Aldred also speak with Angela Thomson, Indigenous Wellness Liaison at St. Paul’s Hospital. Angela highlights how Indigenous Wellness Liaisons strengthen communication and build trust between patients and clinicians, which can promote positive health care experiences. Finally, Dr. Danièle Behn Smith, Deputy Provincial Health Officer for Indigenous Health, explores how Indigenous-specific racism is woven into our health care system and how cultural humility and accountability influence clinical practice. Dr. Behn Smith also discusses systemic barriers to care for Indigenous Peoples and the need for culturally grounded, decolonizing approaches to care.
Access the show notes here.
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In this episode, journalist David P. Ball is joined by Dr. Marcus Greatheart, a family physician, registered social worker, and author. Together, they explore how clinicians can create safe and affirming spaces for trans and gender-diverse youth in substance use care by addressing systemic barriers, promoting trauma-informed approaches, and challenging fear-based narratives. They also speak with Toby and Alec, members of the Substance Use Beyond the Binary Youth Action Committee at the BC Centre on Substance Use. Drawing from their lived experiences with substance use and barriers to gender-affirming care, Toby and Alec offer valuable insights into navigating the healthcare system. Finally, David and Dr. Greatheart hear from family physician Dr. Andrea Moir, who shares lessons from her work providing gender-affirming care for young people. Dr. Moir discusses the impact of stigma, the importance of nonjudgmental approaches, and practical steps clinicians can take to foster more inclusive healthcare environments.
We extend a special thank you to Christian Barborini for their dedication in supporting engagement with the Substance Use Beyond the Binary Youth Action Committee at the BC Centre on Substance Use. Their work was instrumental in facilitating the participation of Alec and Toby in this episode.
Access the show notes here.
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In this episode of the Addiction Practice Pod, journalist David Ball and addiction medicine physician, Dr. Nitasha Puri, discuss the importance of culturally tailored care, drawing on Dr. Puri’s research and experiences from working at Roshni Clinic, which provides care for South Asian adults in Surrey, BC. David and Dr. Puri also speak with Anmol Swaich, a researcher and community organizer with the Surrey Union of Drug Users about the historical context of drug policy and drug criminalization in BC, and its impacts on South Asian communities. Additionally, they talk with Robin, a member of the South Asian Committee with the Surrey Union of Drug Users, about her experiences accessing substance use care as a South Asian woman and what care providers can learn from her journey.
Access the show notes here.
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In this episode, journalist David P. Ball and rural generalist physician and current addiction medicine fellow, Dr. Alison Hamilton, discuss the most challenging and rewarding aspects of working in rural and remote communities. They also speak with Charlene Burmeister, former guest from Season 1, about how the Coalition for Substance Users in the North (CSUN) and other peer-led organizations are meeting the needs of drug users without stigma or judgement. Next, they speak with Juls Budau, former overdose prevention site (OPS) manager in Prince George, about an innovative approach to harm reduction. She also shares her story of opioid use and treatment. Finally, we hear from Jadyn Koldweihe, nursing practice consultant working with rural and remote First Nations communities in BC. Jadyn speaks to infrastructure and geographic barriers to effective substance use care, noting the importance of supports like Traditional Healers and Knowledge Keepers, outreach workers, and community champions. And she models person-centred, trauma-informed, and culturally tailored harm reduction and care.
Access the show notes here.
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In this episode of the Addiction Practice Pod, journalist David P. Ball and perinatal addiction medicine specialist Dr. Eric Cattoni discuss the unique challenges facing people who are pregnant and use substances and the importance of building therapeutic rapport and trust. David and Dr. Cattoni then speak with three experts from the Families in Recovery program at BC Women’s Hospital. They provide care for pregnant individuals who use substances and their newborns in a single unit. We’ll hear from health care administrator Darci Skiber, social worker Meenakshi Mannoe, and peer engagement lead Melissa Dreyer.
Access the show notes here.
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In this episode of the Addiction Practice Pod, journalist David P. Ball and occupational addiction medicine physician and supreme court expert Dr. Deborah Kason discuss how to navigate substance use care for people working in construction and other safety-sensitive jobs. This type of work involves risks of harm to the worker, others, or property if proper safety precautions are not taken. They also speak with Greg Hemminger, who coordinates a harm reduction education program for construction workers called the Tailgate Toolkit and brings his own lived experience of opioid addiction and recovery. For a clinical perspective, they speak with addiction and occupational medicine physician Dr. John Koehn on how he helps his clients re-enter the workplace safely and the power of relationship building in this area of medicine.
Access the show notes here.
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In this episode, award-winning journalist David P. Ball and First Nations Health Authority’s Medical Officer, Mental Health and Wellness, Dr. Nolan Hop Wo discuss the impact of stereotypes related to Indigenous people and alcohol use. Together, they speak with Beryl Parke, a Traditional Wellness Worker at First Nations Health Authority. Beryl is from the Haida Nation and belongs to the Sangalth Stastas Eagle Clan and is currently working in the Kwakwaka’wakw Territory on the lands of the We Wai Kai people in Cambell River, BC. Drawing on her personal experiences and knowledge from practicing in remote First Nations communities, Beryl discusses the importance of alcohol harm reduction and compassionate substance use care.
You can find additional resources and clinical pearls in the show notes: bit.ly/APP-S4E6
Art by Nevada Lynn
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In this episode, award-winning journalist David P. Ball and award-winning family physician Dr. Robert Fox speak with Kali Sedgemore, the president of the Coalition of Peers Dismantling the Drug War and a skilled harm reductionist with a focus on supporting youth. Kali is from 'Namgis First Nation, a small remote island off of Vancouver Island North, and Dr. Fox is a member of the Blood Tribe in what's colonially known as southern Alberta. Together, they discuss reasons for youth substance use and considerations for providers when meeting and caring for young people who use drugs. Kali also speaks to the intersection between Indigenous identity and safer access to substance use care, and about the strengths and resilience of youth.
You can find additional resources and clinical pearls in the show notes, including the article on youth harm reduction calls to action mentioned in the episode: bit.ly/APP-S4E5
Art by Satsi Naziel
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In this episode, award-winning journalist David P. Ball and family physician Dr. Esther Tailfeathers speak with Maura Gowans, a counselling consultant for Indigenous people, about the role that connection to culture can play in healing and wellness. Together, they discuss the importance of bringing together traditional Indigenous approaches and Western approaches to substance use care in the context of the toxic drug crisis. Maura also describes how she creates safe spaces for clients and embeds cultural practices into her life and clinical practice.
You can find additional resources and clinical pearls from the episode in the show notes: bit.ly/APP-S4E4
Artwork by Satsi Naziel
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Addressing the health needs of individuals in remote and rural Indigenous communities, as well as Indigenous people living in urban areas, requires a shift from Western-centric solutions. To emphasize the diversity of Indigenous Peoples, tailored and culturally-relevant approaches are crucial. This can include mobilizing peer and family support, recognizing the significance of culture, Elders, spirituality, and building community capacity through sustainable funding of Indigenous-led programs.
In this episode of the Addiction Practice Pod, award-winning journalist David P. Ball and family physician Dr. Esther Tailfeathers discuss the realities of substance use care in Kainai Nation, a rural community where Dr. Tailfeathers works. We also hear from Helen Knott, award-winning author and founder of Indigenous wellness program Fierce With Heart, about her own healing journey and relationships to substance use, the land, and health care systems.
You can find additional resources and clinical pearls from the episode in the show notes: bit.ly/APP-S4E3
Artwork by Nevada Lynn
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Navigating abstinence-based perspectives in substance use care can be complex. Within Indigenous communities, these complexities also intersect with the impacts of colonialism. Abstinence-based perspectives may arise or align with Indigenous teachings, they may stem from imposed colonial values, or both may be true. It is important to recognize that there are a variety of explanations for why abstinence-based approaches may be promoted, and that these can offer a healing path for individuals when aligned with Indigenous worldviews.
In this episode of the Addiction Practice Pod, award-winning journalist David P. Ball and First Nation Health Authority’s Medical Officer of Mental Health and Wellness, Dr. Nolan Hop Wo, discuss potential benefits and harms from abstinence-based approaches to substance use care. We also hear from Keshia Cleaver, Harm Reduction and Program Advisor with The Four Directions Team at First Nations Health Authority, on why abstinence-based perspectives are common in some Indigenous communities, and how to meet communities where they are at with harm reduction.
You can find additional resources and clinical pearls from the episode in the show notes: bit.ly/APP-S4E2
Artwork by Brianna Bear
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The ongoing impacts of colonization continue to affect the health and wellness of Indigenous Peoples, evident in the disproportionate rates of toxic drug poisonings and deaths experienced by Indigenous people as compared to non-Indigenous people. Addressing the harms related to substance use in these communities involves acknowledging and reducing the harms of colonialism, while emphasizing and building upon the strengths and resilience of Indigenous Peoples.
In this episode of the Addiction Practice Pod, award-winning journalist David P. Ball speaks with the Medical Officer of Mental Health and Wellness at First Nations Health Authority, Dr. Nolan Hop Wo, on how colonialism and substance use are related. We also hear from Lacey Jones, Program Director of QomQem Coastal Connections, on strengths-based approaches to reducing the harms associated with colonialism.
You can find additional resources and clinical pearls from the episode in the show notes: bit.ly/APP-S4E1
Artwork by Brianna Bear
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Families, including chosen families, can be an extremely important source of support in a person’s substances use care journey, but are often overlooked in substance use care planning.
In this episode of the Addiction Practice Pod, co-hosts David Ball and Christina Chant discuss the complexities and strengths of involving families in substance use care. In a slight departure from usual programming, Christina is joined by her sister, Lauren Chant, to provide their unique perspectives as both clinicians and family members with years of experience navigating the health care system.
We'd love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep6
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Prescribed safer supply aims to provide access to a legal and regulated supply of drugs, in order to reduce the risk of harms and death associated with using the increasingly toxic unregulated drug supply. In this episode of the Addiction Practice Pod, Dr. Marcus Greatheart and journalist David Ball discuss prescribed safer supply with guests who have on-the-ground experience.
First, we hear from harm reduction nurse educator Corey Ranger, on the concept of a “safer supply”, and steps clinicians can take to make prescribed safer supply programs more effective. Corey also shares some lessons learned from participants at the Victoria SAFER Initiative, a prescribed safer supply program in Victoria, BC. From Safer Opioid Supply (SOS) in London, Ontario, Dr. Andrea Sereda discusses the importance of listening to your client’s needs when it comes to their substance use, including what they need to reduce their reliance on the unregulated supply, and shares some preliminary data from SOS. We also hear from the co-founder of the Coalition of Substance Users of the North (CSUN), Jenny McDougall, on the importance of providing lower-barrier care options for individuals who are experiencing harms from the unregulated drug supply.
We'd love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep5
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Introducing the Addiction Practice Pod
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Through providing small doses of alcohol to clients regularly, managed alcohol programs reduce the risks associated with heavy drinking and non-beverage alcohol consumption without requiring abstinence.
In this episode of the Addiction Practice Pod, Dr. Marcus Greatheart and David Ball talk with public health researcher and executive director of the Vancouver Area Network of Drug Users, Brittany Graham, about the purpose of managed alcohol programs and how they fit into the continuum of care for alcohol use disorder. We also hear from harm reduction advocate and peer leader, George Sedore, about what led him to join a managed alcohol program and how this has impacted his life.
We'd love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep4
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Urine drug testing (UDT) is an important part of providing care to individuals with substance use disorders, from confirming baseline substance use to evaluating treatment outcomes. However, many individuals have had negative experiences with UDT. When UDT procedures feel punitive, it can impact whether an individual will continue to access care.
In this episode of the Addiction Practice Pod, Dr. Marcus Greatheart and David Ball talk with family nurse practitioner Tracey Day about how to effectively communicate with a patient about UDT and build a care plan collaboratively. We also hear from peer navigator and clinical care advocate Reija Jean, on the impact of negative UDT experiences, and how care providers can build respectful and safe therapeutic relationships.
We'd love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep3
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Individuals and communities in BC are facing an increased risk of stimulant-related harms. Stimulant use can cause significant harms on its own, including negative cardiac and mental health outcomes. In the context of the unregulated drug supply, toxic drug poisonings can occur due to contamination of stimulants with opioids and other substances.
In this episode of Addiction Practice Pod, Dr. Marcus Greatheart and David Ball talk with addiction psychiatrist Dr. Julius Elefante about harm reduction and treatment for stimulant use disorder. We also hear from the executive director of UNDU, Katt Cadieux, on the importance of trusting your patient and building a care plan based on their lived experience.
We'd love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep2
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Alcohol withdrawal management is an important part of the continuum of care for alcohol use disorder. While some individuals at low risk of complications can safely undergo alcohol withdrawal at home, others may require inpatient withdrawal management services to prevent life-threatening complications.
In this episode of Addiction Practice Pod, Dr. Marcus Greatheart and David Ball talk with clinical nurse specialist Avee Khela about alcohol withdrawal management pathways, and we hear from Sandra Stewart on the importance of compassionate, non-judgemental care.
We'd love to hear your feedback after the show. Find our evaluation, along with our show notes, here: bit.ly/APP-s3ep1
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In Canada and around the world, colonial histories continue to influence people's access to determinants of good health. Our society continues to advantage White people, and addiction medicine is no exception.
In this episode, Dr. Robert Fox, David Ball, and their guests discuss the intersections of race, ethnicity, and substance use. How can we make our clinics more accessible for people of different racial and ethnic identities? How can we unlearn our own racial prejudice? In this episode, we use the term ‘racialized’ to indicate groups who are marginalized according to race as a part of their identity.
We’d love to hear your feedback after the show. Find our evaluation, along with our show notes here: https://bit.ly/3uJPAe2
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