This week, we wanted to take some space to discuss the Opioid Crisis in Canada and more specifically, how it has affected Hamilton, ON.

Last week, Public Health released the following statement:
February 1, 2019: Purple Heroin Alert – Public Health Services has received reports of overdoses due to Purple Heroin, a highly toxic synthetic laced heroin, circulating the community. People say it can cause confusion, and speech problems. People also say it can cause nausea, vomiting and diarrhea for several days after. This serves as an important reminder to the community that street drugs continue to be cut (mixed) with toxic substances.

There is no easy way to know what is in your drugs. You can’t see it, smell it or taste it. Substances such as fentanyl and carfentanil can be cut (mixed) with other drugs. Even a very small amount can cause an overdose.

As of February 3, Hamilton Paramedic Services have responded to 65 incidents related to opioid overdoses this year. This number is evidence that this is a very real problem in our community.

Public Health recommends the following steps to stay safe:

• Careful Use – Don’t use alone, go slow by testing the effect with small amounts first.
• Carry naloxone – Get a FREE naloxone kit, and training at the following locations:
  City of Hamilton Public Health Services Harm Reduction program: 905-546-4276.
  Participating local pharmacies by calling the Drug and Alcohol Helpline: 1-800-565-8603.
• Call 9-1-1 for every overdose. You, your friend or family member needs hospital care to survive.
• CPR. Push Hard, Push Fast.

If you wish to learn more information about the Opioid Crisis in Hamilton, click here.

Bones can lose density with age making them more likely to break when having a fall.  Loss in bone density and quality can also occur due to certain medical conditions (ex. rheumatoid arthritis, Crohn’s disease and ulcerative colitis) and certain medications (ex. prednisone). This bone weakening can progress to osteoporosis, requiring prescription treatment to reduce the risk of a fracture.  Beyond prescription treatments, along with calcium and vitamin D, preventing falls is one of the best ways to reduce fracture.  With the influx of snow and ice over the last couple of weeks, this is a good time to review strategies to prevent falls.

Autoimmune diseases are more common and may also progress at a greater rate amongst those who smoke tobacco. Treatments such as biologics don’t work as well in people who continue to smoke. At Charlton Health we are happy to assist people in quitting smoking.

Heart disease is greater in those who smoke and in conditions with high inflammation, heart disease is also higher than in the general public. Many of the conditions we treat also have potential lung complications, and of course smoking increases lung damage.

For all these reasons, quitting smoking is the best thing a person can do for their health, and even more so for people with the conditions listed above.

This week, as National Non-Smoking Week, is a good time to think about quitting. If you need assistance or strategies, or a better understanding of the treatment options available, please reach out to us. We look forward to working with you.

Learn more about National Non-Smoking Week here.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

Well, we are officially 1 year into our Hepatology program and treatment for Hepatitis C continues to be a very exciting area for us at Charlton Health.  With EVERYONE now being funded for the cure of hepatitis C, we continue to accept new patients and referrals to our program.

Are you living with Hepatitis C or know someone who is??  Everyone is now funded and offered the cure for this virus as Canada works hard to eradicate Hepatitis C completely.  If you have Hep C or know someone who does, please have the family doctor send a referral to one of our Hep C programs to discuss treatment.

Hamilton– Dr. Marco Puglia

Phone 905-526-7002 x 1104

Fax 905-522-7477

Brantford– Dr. Stephen Somerton

Phone 519-756-3830

Fax 519-756-6315

Jennifer Heipel has approximately 12 years of experience working as a hepatology nurse/clinical research coordinator for several gastroenterologists, hepatologists, infectious diseases and addiction specialists. She is trained in the treatment of Hepatitis B and C therapies as well as general hepatology and pre/post liver transplant follow up. Jennifer serves as Charlton Health’s full time Hepatology Nurse and manages the Hepatology Program. She has worked and continues to work with Dr. Puglia at McMaster University and other area Gastroenterologists to develop a comprehensive, in-house Hepatology program and Hepatitis C program here at Charlton Health.

Happy New Year! With 2019 just beginning and countless year-end lists from 2018, we thought we would share our Top 5 Blogs of 2018. Here they are, in case you missed them!

5. The use of Fibroscan to determine if you have liver disease
4. Fatty Liver Disease: Part 1
3. New Treatment on The Horizon For Ulcerative Colitis
2. Raynaud’s Phenomenon is more than cold hands and feet
1. The Ontario Government Extends Coverage of Prolia to Men

We hope you enjoyed learning with us throughout 2018. We’re excited to bring you lots of new helpful information in 2019!

• An automated phone call will be made to advise you of the date of medication delivery or clinic appointment. ​
• If you are able to answer the call, you will be asked to press “1” to confirm the delivery/appointment date or press “2” to reschedule. ​
• If you press “2”, one of our team will call you back to make alternate arrangements.
• The system will make three attempts to call you and will only leave a message on the third attempt.  If there is no answer on the third try, a message will be left  with your delivery/appointment details.

We hope you find our new system helpful and efficient. If you have any questions, please do not hesitate to contact us.

We’ve written about Project ECHO in the past and today we’re excited to bring you more information about this great initiative. ECHO (Extension of Community Healthcare Outcomes) is a not-for-profit project that was initiated in New Mexico by a hepatologist to educate community health care providers on Hepatitis C treatments. Weekly two-hour sessions include a small lecture followed by the presentation of patient cases by the community members who are attending via online video conferencing. The community members are often family physicians, nurse practitioners, pharmacists, chiropractors, physiotherapists, naturopaths etc., After attending the weekly sessions, community health professionals feel confident in initiating treatments that patients would have otherwise had to wait to see the specialist.

Ontario is the first Canadian province to launch Project ECHO and it is funded by the Ministry of Health and Long Term Care. For the last two years there has been a specific ECHO session for Rheumatology. There are also sessions for hepatology, chronic pain, and mental illness. I have had the pleasure to serve as the pharmacist expert for the ECHO Rheumatology sessions.

Last Saturday many of the community members had the opportunity to meet face to face at a ‘bootcamp’ held in Toronto. The highlight of the session was the patient partners who educated the community members on how they live with inflammatory arthritis. If you know of health professionals in the community that would like to learn more about rheumatology or the other sessions held by ECHO refer them to;

Toronto Rehabilitation Institute, University Centre
550 University Avenue Room 7-141
Toronto, ON M5G 2A2
PH: 416-597-3422;4435
E: echo.ontario@uhn.ca

Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

At the October American College of Rheumatology meeting in Chicago, research from around the world was shared.  A featured study regarding osteoarthritis assessed 240 patients, half using acetaminophen and anti-inflammatory medications and the other half using opioid medications (codeine, morphine, hydromorphone, fentanyl etc.) They compared the level of general pain intensity and pain related to movement for the two groups. The intensity of pain was lessened in the group NOT using opioids. Pain with movement was no different between the two groups. This information emphasizes the need to avoid opioid use in osteoarthritis.

Weight loss and continued movement are the main focus of treatment. Even while sitting, keeping moving is important. Pushing through some discomfort to maintain movement and lubrication of joints is vital. Water exercise programs are also very beneficial for those with limited mobility. An example of these programs is the GLA:D physiotherapy program, which was first established in Denmark and is now offered at many centres in Canada. It is a well researched program showing improvement in osteoarthritic joints.

Stay tuned for more information on osteoarthritis…