Mental Health and Addictions Service
Addiction Services
St. Michael’s Hospital is a provincial addiction treatment leaderAt St. Michael’s Hospital we pride ourselves on having created an interdisciplinary addictions model which integrates evidence-based addiction medicine and addiction psychiatry principles in a way that is unique in North America. Our day-to-day clinical team consists of addiction experts from family medicine, psychiatry, internal medicine and emergency medicine. In addition, patients are seen by and cases discussed with our case managers, nurse practitioners and, perhaps most importantly, peer support workers with lived addiction experience. Learn moreWe treat all addiction types, often called in to see patients with whom engagement is difficult or who are at high risk of death or leaving hospital against medical advice. For people who use opiates we offer a wide spectrum of services from harm reduction (safe injecting practices, naloxone kits etc) to psychosocial and medical treatments. Not only are all of our treatments trauma informed, we also provide both first stage trauma treatment (through Seeking Safety and DBT) for individuals at the beginning of their recovery journey but also addictions-informed trauma therapy for those prepared for the later stages of trauma recovery. We have made a concerted effort to address the paucity of services available to men with traumatic experiences in their history. Physicians in the Emergency Department are trained in the use of opiate replacement therapy but frequently call on our inpatient consultation team to see patients. Once admitted, patients are followed closely by this inpatient team who work to reduce risk of overdose and loss of drug tolerance for high risk users, keep people in hospital and initiate medication assisted treatments. Simultaneously, patients are integrated into robust and evidence-based group therapies working to engage patients and eventually into first stage trauma therapy or more intensive therapy to overturn underlying conditions driving drug use. In some cases when appropriate family therapy is offered. Once discharged, patients are retained in our groups but also offered outpatient follow-up within 24 to 48 hours in our Rapid Access Clinics which have been operating successfully for five years where again medication assisted treatment but also psychosocial interventions are available. We also work to manage pain cases in consultation for which opioid dosing has become high risk. For patients with addiction and pregnancy comprehensive and innovative antenatal and addiction care is offered by members of the Family Health Team. Many physicians in the Family Health Team have been trained in addiction and offer addiction treatment in conjunction with primary care. More than 50 medical trainees from all discipline lines rotate through our service yearly and are jointly supervised by the interdisciplinary medical team. However, education extends beyond medical students and residents: we frequently give hospital rounds on harm reduction, motivational interviewing, addiction principles and opioid prescribing social workers and case managers from other organizations are trained in group psychotherapy and more than 200 practicing physicians have received training in medication assisted treatments such as buprenorphine. Scholarship is important to our department as we search to build robust evidence for innovation in addictions. We are working to write up case series on our innovative treatments including more comfortable initiation of buprenorphine and greater integration of harm reduction in hospital. We are working on designing a number of clinical trials as well. Together, we believe St. Michael's can serve as an example for comprehensive and interdisciplinary addiction care in Canada and internationally. |
The Addictions Team is an interdisciplinary team comprised of an addictions nurse practitioner, case manager, discharge planner, certified addiction medicine specialists from Medicine, Family and Community Medicine and Psychiatry providing consultation, treatment and care to complex patients with primary and comorbid addictions.
Addictions teamThe Addictions Team provides specialized addictions assessment, treatment and connection to community resources for patients experiencing difficulties or problems with alcohol and/or drug use in St. Michael’s Emergency Department and inpatient units. Learn more
The addictions team consists of an addictions medical physician, addictions psychiatrists, nurse practitioner and addictions community worker.
Eligibility criteria Patients currently admitted into hospital (including Crisis Stabilization Unit). How to access the service For further information please page 416-864-5120. |
Coordinated Access to Addictions ServicesCoordinated Access to Addictions Services is a central number that individuals, family members and community agencies can call for guidance and referrals to substance abuse support services within the City of Toronto. Learn moreServices offered Coordinated Access professionals assist in determining a caller’s next step on their path to recovery. We match individual needs with one of more than 30 partnering agencies available in the city of Toronto. Services include:
Eligibility criteria
How to access the service Through 1-855-505-5045 clients can speak to an addictions counselor who will assist them in finding the appropriate level of care for their needs. *Voicemail messages left after hours will be returned the next business day. Download Coordinated Access to Addictions Services document (58 kb pdf file) |
Mens Residential Withdrawal Management ServiceResidential withdrawal management center for support through the withdrawal process staffed by sensitive, respectful, well trained professionals. Learn moreServices offered
Eligibility criteria Residential Withdrawal Management Services are for:
How to access the service Withdrawal management (“detox”) services are available upon self or health provider referral. To access please call the central access number 1-866-366-9513. |
Mens Community and Day Withdrawal Management ServiceCommunity and Day withdrawal programs are structured day-time withdrawal management programming and support. Day withdrawal is offered on-site as well as community locations. Learn moreServices offered
Eligibility criteria Residential Withdrawal Management Services are for:
How to access the service To access Men’s Community and Day Withdrawal Programs please call the central access number 1-866-366-9513 |
Rapid Access ClinicsAlert for Rapid Access Clinic patientsIf you have been to RAC before:Effective immediately, we are offering a virtual clinic. If you would like your prescription refilled, changed or would like to speak with a doctor please call 416-864-3082. You will receive a callback with an appointment time within clinic hours. The RAC clinic is held on Mondays and Fridays from 9 - 11:30 a.m. Is this your first time visiting the RAC?Please come in person for your first visit. We are located on the 1st floor Rotary Centre Bond Wing Monday and Friday, 9 - 11:30 a.m. If you have any questions, please call 416-864-3082 This is an urgent care, drop in service for people with addiction disorders who required emergency room or hospital in-patient care. Learn moreThe clinic operates Monday, Wednesday and Friday from 9 to 11 a.m. The RAC physicians and the nurse practitioner are available to immediately address semi-urgent (but non-emergent) addictions medicine care such as opiate replacement therapy, benzodiazepine stabilization and tapering, alcohol anti-craving medication and non-urgent alcohol withdrawal protocols. The community addiction worker provides follow-up care focused on community linkages and treatment matching. Services offered The RAC offers medications for withdrawal and alcohol craving (e.g. Naltrexone) or opiate agonist therapy (e.g. methadone or Suboxone). If you have already been started on methadone or Suboxone you will have to return to your original prescribing doctor. The RAC will not be able to assist you if you are requesting narcotics, benzodiazepines or pain management. Eligibility criteria The RAC is accepting all clients. For more information please call 416-864-3082, or Coordinated Access at 1-855-505-5045. Direct the patient to come any (non-statutory holiday) Monday - Friday at 9 a.m. to 17th floor outpatient registration desk and let the receptionist know that they are here for Rapid Access Clinic. |
Addictions groupsOur first stage engagement group is designed to help you identify any issues with your substance use and help you make changes, whether your goal is a harm reduction approach or abstinence. Learn moreYou may be referred to this program if you need help with any of the following:
Services offered Once you have established a goal, you will have the option to join our second stage group that uses practical approaches to continue to assist you with achieving your goal. The Addiction Team here at St. Michaels wants to engage with you even if you’re unsure of your goal or if a more comprehensive treatment plan is needed. Please feel free at any time to speak with one of our facilitators if you have any questions. In general, we offer two main groups, one is called the Engagement Group where we assist you in developing goals for your own recovery and the second Community Reinforcement Group is an early stage treatment group that will you look at both mental health and substance use problems. If when we meet, we agree that you need more or different services, we will work to get you connected to other treatment options that can better meet your needs.Eligibility criteria Patient eligible if:
Please note groups are conducted in English. How to access the service FAX completed referral form to: 416‐864‐3091,
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Services offered
30 Bond St.
Toronto, Ontario
M5B 1W8
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TTC directions to the Hospital
1. Exit at Queen station. The Queen station is on the Yonge-University-Spadina subway line.
2. Then walk one block east on Queen St. to the Queen entrance.
Driving directions from the Don Valley Parkway
1. Exit at Richmond St.
2. Go west to Church St.
3. Go north to Queen St.
4. Go west to Bond St.
From the Gardiner Expressway
1. Exit at Jarvis St.
2. Go north to Shuter St.
3. Go west to Bond St.
