Smoking/Substance Abuse

  • Describe use of appropriate tools for asking about substance and alcohol abuse
  • Initiate a discussion around substance abuse using motivational interviewing or assessing for readiness for change
  • Describe target organ damage due to substance abuse (i.e. Alcohol)
  • List some community resources and other health care professionals who could be part of the care-team in the patient suffering from substance abuse.
  • List the evidence based interventions one should address for all smokers
  • Assess the patient for readiness to quit
  • Advise patients on quitting or benefits of quitting
  • Assist patients in quitting by giving them options: 
    • Describe the various nicotine replacement forms, how they are used and how to advise patients on how much to use
    • Explain the use of prescription medications, effectiveness and side effects
    • Describe the long term follow up of these patients

Articles

Substance Addictions Clinical Card

Taylor RC, Tink W. Keegan DA. Substance Addictions. Canadian Family Medicine Clinical Card. 2014. Available at: https://sites.google.com/site/sharcfm/

Alcoholism

Munroe S, Clarkson B. Alcoholism One-Page Primer. DFCM Open. 2011. Available at: http://dfcmopen.com. Attribution CC BY-NC-ND

Canada’s Low-Risk Alcohol Drinking Guidelines

Canadian Centre on Substance Abuse. Canada’s Low-Risk Alcohol Drinking Guidelines. 2013. Available at: http://www.ccsa.ca/

Alcohol-Related Problems_ Recognition and Intervention - American Family Physician

Burge SK, Schneider FD. Alcohol-related problems: Recognition and intervention. Am Fam Physician. 1999;59(2):361-70, 372.

Canadian Smoking Cessation Clinical Practice Guideline

CAN-ADAPTT. (2011). Canadian Smoking Cessation Clinical Practice Guideline: Summary Statements. Toronto, Canada: Canadian Action Network for the Advancement, Dissemination and Adoption of Practice-informed Tobacco Treatment, Centre for Addiction and Mental Health.

Resources for Smokers

CAN-ADAPTT. (2011). Canadian Smoking Cessation Clinical Practice Guideline: Summary Statements. Toronto, Canada: Canadian Action Network for the Advancement, Dissemination and Adoption of Practice-informed Tobacco Treatment, Centre for Addiction and Mental Health.

Tobacco Algorithm updated May 2016

Centre for Addiction and Mental Health Nicotine Dependence Service. Algorithm for Tailoring Pharmacotherapy in Primary Care Settings. Created March 2012. Updated. May 2016

CEP_Guide for Primary Care Management of Mental Health and Addictions

Centre for Effective Practice in collaboration with Ontario College of Family Physicians and Nurse Practitioners’ Association of Ontario.  Keeping Your Patients Safe: A Guide to Primary Care Management of Mental Health and
Addictions-related Risks and Functional Impairments.  February 2017.

Simplified Guidelines for Prescribing Medical Cannabinoids in Primary Care.pdf

Allan GM, Ramji J, Perry D, et al. Simplified guideline for prescribing medical cannabinoids in primary care. Can Fam Physician. 2018; 64(2) 111-120.

Guideline for opioid therapy and chronic noncancer pain.pdf

Busse JW, Craigie S, Juurlink DN, et al. Guideline for opioid therapy and chronic noncancer pain. CMAJ May 08, 2017; 189 (18) E659-E666. doi: https://doi.org/10.1503/cmaj.170363