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In the patient with a substance use problem

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Substance use problems: When to refer to a specialist

Consider specialist referral in these situations:

  • Diagnostic clarification is required.
  • The severity or complexity of the presentation is beyond your expertise.
  • The patient requires support and services provided by a specialized centre (e.g., for pregnant women, trauma victims, youth).
  • The patient has multiple problems that could benefit from multidisciplinary case management
  • The patient has only a partial response or no response to treatment.
Adapted from: Agnes Kwasnicka and Peter Selby, The patient with a substance use problem Psychiatry in Primary Care (CAMH, 2011)

Psychiatry in primary care toolkit

The Psychiatry in Primary Care App has been decommissioned. 

The revised print version of Psychiatry in Primary Care is avaible through the CAMH store. 

We have posted a number of revised chapters from the book in Treating Conditions and Disorders in the new Professionals section of camh.ca. 

Clinical guidelines

Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence (NICE guideline CG115, 2011)

BC Guidelines: Problem Drinking

Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain (National Opioid Use Guideline Group (NOUGG), 2010)

Buprenorphine/Naloxone for opioid dependence: Clinical practice guideline (CAMH, 2012)

Canadian Smoking Cessation Clinical Practice Guideline (CAN ADAPTT, 2011)

Supporting smoking cessation: a guide for health professionals (Royal Australian College of General Practitioners, 2011, 2014)