First of five planned ‘barrier fee’ addiction clinics opens in Toronto

A Toronto hospital says the city’s first “barrier-free” addiction clinic will reduce the wait times to days from up to months for patients seeking treatment.

The clinic at Women’s College Hospital is one of five walk-in addiction clinics that are to open in Toronto in the coming months under a new provincial initiative called Mentoring Education and Clinical Tools for Addiction: Primary Care-Hospital Integration.

Project manager Kate Hardy says the clinic is described as barrier-free because patients with alcohol, opioid or other addictions don’t require a booked appointment or a referral from a doctor.

Hardy says seven similar clinics opened in other Ontario cities about 15 months ago and have been credited with preventing opioid overdoses, reducing emergency-room visits and inpatient stays for people with addictions.

She says five of those sites saved the health-care system an estimated $200,000 for the first 150 patients in their first 90 days of treatment.

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Opioid and alcohol abuse are the main addictions the clinics are treating, but Hardy says doctors are seeing an increase in people seeking help for cannabis use disorder.

“Typically, patients in crisis end up at emergency departments where they often don’t get the treatment they need,” she said. “We also saw a dramatic reduction in hospital use by the patients that were seen in these rapid-access clinics.”

Hardy said the first rapid-access clinics that opened in Sudbury, Owen Sound, Sarnia, St. Catharines, Newmarket, Ottawa, and London, saw nearly 900 patients in the first year of operation.

“We got some really promising data out of those sites in terms of need that was seen in these communities,” she said. “The rapid-access clinics were certainly well used.”

Hardy said the wait time for some addiction treatment can be up to eight months, but the rapid-access clinics will see patients in under three days.

The clinic at Women’s College Hospital has only been operating for only a few weeks, but is already getting good feedback from patients.

“I was able to walk in, see the doctor right away and get medication all on the same day,” said Tracy Shillington. “This has made a difference between life and death for me.”

Hardy said most patients seek treatment for alcohol addiction, but Dr. Meldon Kahan, medical director of substance use service at Women’s College Hospital, said “the opiate crisis we’re seeing now has reached epidemic proportions.”

The rapid-access clinic model “offers us a realistic and effective response to this crisis,” Kahan said.

Recent studies show that there were 734 opioid-related deaths in Ontario in 2015, exceeding the number of people killed in motor vehicle collisions.

The hospital said the rise of fentanyl – a powerful opioid that’s 50 times stronger than heroin – has likely contributed to the increase in accidental deaths, as it is often added to other drugs to increase potency.

Experts now see opioid addiction across all ages and socioeconomic backgrounds, but reports indicate nearly 60 per cent of accidental deaths occurred among those between 15 and 44 years old, the hospital said.