title: Facilitating medical withdrawal from opiates in rural Ontario.
abstract: BACKGROUND
  The abuse of oxycodone in Northwestern Ontario, Canada, has escalated at alarming rates raising concerns that opiate use has reached epidemic proportions, particularly among the First Nations communities. The authors were involved in establishing Ontario's first rural inpatient medical withdrawal unit to serve patients seeking abstinence.
  
  
  OBJECTIVE
  The development of the medical withdrawal support services (MWSS) required creative and adaptive strategies to respond to the geographical, cultural and institutional circumstances.
  
  
  CONCLUSIONS
  Key factors to support program efficacy and successful outcomes for clients during the inaugural eight months of operation are interprofessional and collaborative approaches with a cultural awareness.Key words: addiction, Canada, First Nation, medical withdrawal.
authors.affiliation: Northern Ontario School of Medicine, Sioux Lookout, Ontario, Canada. niki.kiepek@gmail.com
authors.forename: N
authors.initials: N
authors.lastname: Kiepek
authors.forename: L
authors.initials: L
authors.lastname: Hancock
authors.forename: D
authors.initials: D
authors.lastname: Toppozini
authors.forename: H
authors.initials: H
authors.lastname: Cromarty
authors.forename: A
authors.initials: A
authors.lastname: Morgan
authors.forename: L
authors.initials: L
authors.lastname: Kelly
mesh_terms: D044467:American Indian or Alaska Native; D003376:Counseling; D054521:Cultural Competency; D005260:Female; D006303:Health Services, Indigenous / Q000592:standards; D006760:Hospitalization; D006801:Humans; D008297:Male; D009292:Narcotic Antagonists / Q000627:therapeutic use; D009864:Ontario; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000208:ethnology / Q000534:rehabilitation / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D011247:Pregnancy; D019035:Rural Health Services; D013375:Substance Withdrawal Syndrome / Q000208:ethnology; D014505:Urban Population
chemical_list: D009292:Narcotic Antagonists