ADAPT Community Withdrawal Management Services (CWMS) Presented By: Carrie Woodcock, Program...
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ADAPTCommunity Withdrawal Management Services
(CWMS)Presented By: Carrie Woodcock, Program Manager
A partner in service funded by the Mississauga Halton LHIN Community
Concurrent Disorders Program (CCDP)
Working Together Towards Recovery
Community Withdrawal Management Services (CWMS) offers an alternative to residential withdrawal management for individuals who can safely withdraw from substances in a supportive community environment.
Services include pre-withdrawal planning, acute withdrawal monitoring and post acute withdrawal support and transitional case management.
About CWMS / Case Management
When a person stops using alcohol and/or other drugs their body and mind may experience physical and/or emotional symptoms.
Withdrawal can be a very uncomfortable process physically, mentally and emotionally
In some cases, it can feel like a terrible flu and even cause confusion and delusions. Others may experience very few symptoms.
Understanding Withdrawal
Alcohol Onset: Generally within 24 – 48 hours of last
drink depending on amount consumed. Duration: Typically between 3-7 days, can be up
to 14 days in severe cases. Symptoms: May include anxiety, agitation,
sweating, tremor, headache, nausea, vomiting, abdominal cramps, difficulty sleeping and changes in blood pressure. In addition some individuals may experience seizures, hallucinations or delirium tremens (DT’s).
Common Withdrawal Symptoms
Opiates (Oxy, Percs, Morphine, Heroin etc.) Onset: Generally within 8-24 hours of last use.
Often will peak within 2-4 days. Duration: Can last up to 7-10 days for most and
3-6 weeks for methadone. Symptoms: May include anxiety, craving,
muscle tension, muscle and bone ache, muscle cramping, sleep disturbances, sweating, hot and cold flushes, goose bumps, yawning, nausea, vomiting, abdominal cramping, diarrhea, palpitations, high blood pressure and agitation.
Common Withdrawal Symptoms
Benzodiazepines (Valium, Ativan, Clonazepam, Diazepam etc.)
Onset: Within 1-10 days of last use depending on the drug.
Duration: Generally 3-6 weeks (or longer) Symptoms: May include anxiety, headaches,
muscle aching, twitching, cramping, nausea, vomiting, diarrhea, perceptual changes, feelings of unreality, seizures, agitation, confusion and psychosis.
Common Withdrawal Symptoms
Cocaine / Crack Onset: Crash within hours of last use. Duration: Typically 1-4 days after last use Symptoms: May include cravings, irritability
fatigue, nightmares, difficulty sleeping, increased appetite, agitation, restlessness and slowed physical movements.
Common Withdrawal Symptoms
Cannabis Onset: Generally within 1-2 days of last use. Duration: Typically between 2-6 days (acute
withdrawal) decreasing after 2-6 weeks. However can last up to several months. Symptoms: May include anger, aggression, irritability, anxiety, nervousness, decrease in appetite, restlessness, difficulty sleeping, chills, low or depressed mood, shakiness and sweating.
Common Withdrawal Symptoms
Methamphetamines (Crystal Meth) Onset: Crash within hours of last use. Duration: Typically 1-4 days after last use. Symptoms: May include cravings, dysphoria,
lack of pleasure, increased appetite, fatigue, agitation, anxiety, increased sleep, vivid, unpleasant dreams and slowing of movement.
Common Withdrawal Symptoms
If at any time the following symptoms are experienced it is advised that the individual seek medical attention or go to your local
urgent care center or emergency department. Vomiting that won’t let up or vomiting blood Persistent diarrhea Difficulty breathing, shortness of breath, or very rapid breathing Sudden chest pain or severe abdominal pain Having or had a seizure (a spastic convulsion of the body) Severe body shakes and chills Recurring hallucinations Severe agitation and you can’t calm down Confusion or disorientation Feel at risk of self harm or suicidal thoughts. Support is available,
contact COAST Halton @ 1-877-825-9011, the police or 911 if there is immediate risk.
Complications
Consistent with provincial admission criteria for CWM
Informed by Best Practices for Concurrent Disorders
Included a review of existing service models (ASYR, FourCAST, PAARC)
Program Design Considerations
Currently intoxicated, with withdrawal or in crisis related to substance use.
Wanting to stop use of alcohol and/or other drugs.
Screening and assessment are a critical element to determine appropriate level and intensity of service required.
Must meet criteria for CWM admission
Admission Criteria
Phone Screening/Intake CWMS Assessment (face to face) Individual and Group Withdrawal
Management Counselling Pre Withdrawal Planning Withdrawal Monitoring (Acute & Post
Acute) Transitional Case Management Treatment Assessment and Referral
Program Overview
RN & RPN available for consultation and support
Drop In Groups (coming)◦ Weekday Early Recovery/Support◦ Weekend Planning/Support
Family/Support Consultation Mobile Outreach and Home Withdrawal
available for individuals within the Halton Region
Program Overview
Referral Sources:◦ CCDP Partners (CMHA –Crisis & Case
Management)◦ ADAPT Intake◦ ADAPT Active Clients◦ Physician/Hospitals◦ Residential Withdrawal Management Services◦ Self Referral ◦ Other Community Agencies
Accessing ADAPT CWMS
Withdrawal Management Counsellors/Transitional Case Managers◦ Shannon Bovie◦ Priya Chauhan◦ Jim Spradbrow
Registered Nurse (RN)◦ Trish Aleve
Registered Practical Nurse (RPN)◦ Siobbhan Boyter
Program Manager◦ Carrie Woodcock
CWMS Team
Contact Information
CWMS Intake:Halton Region Local: 905-827-5320Toll Free: 1-877-517-2237
Fax: 905-847-8959www.haltonadapt.org
Carrie Woodcock, B.A., Grad Dip. ACWProgram ManagerP: 905-875-9678E: [email protected]
Thank You!