TY - JOUR
AU - C. G. Schütz
AU - T. Nicholls
AU - L. Schmid
AU - S. Penner
AU - M. Massey
AU - K. A. Thiessen
AU - S. Todesco
AU - R. Rafizadeh
AU - K. Cowie
AU - S. K. Syan
AU - J. MacKillop
A1 - 
AB - ObjectiveThis paper summarizes methods and initial overdose-related results from the Reducing Overdose and Relapse: Concurrent Attention to Neuropsychiatric Ailments and Drug Addiction (ROAR CANADA) project. ROAR CANADA is a longitudinal observational study of individuals with severe concurrent substance use and mental disorders (also called dual disorders or dual diagnosis). The study sampled patients treated at two tertiary treatment centres in British Columbia, Red Fish Healing Centre and Heartwood Centre, along with a concurrent treatment unit at St. Joseph's in Ontario. These facilities have implemented evidence-based integrated treatment programs. Our first analysis explores selected baseline characteristics as potential risk factors for drug overdose in this population.MethodSociodemographic factors, trauma history, and impulsivity were part of a more comprehensive longitudinal assessment. In this first investigation, we use bivariate analysis and logistic and linear regression modelling to examine these variables in relation to overdose history.ResultsOverall, 291 of 450 participants (64.7%) reported a history of ≥1 overdose. Across the three centres, patients had a lifetime average of 7.6 (SD = 12.9) overdoses. The prevalence and mean number of overdoses were somewhat higher among Red Fish patients (74.5% and 8.5, respectively). Adverse childhood events, lifetime trauma history, and impulsivity were all high, but only lifetime trauma history emerged as significantly associated with overdose across all treatment centres. Impulsivity indicators were selectively associated with overdose by site, but not consistently within the overall sample.ConclusionsThese results highlight the importance of prioritizing trauma-informed care in the treatment of individuals with severe concurrent substance use and mental disorders, who are at high risk of overdose. The integration of trauma treatment into existing programs may enhance patient outcomes and contribute to the ongoing evolution of effective care strategies for this complex population. These findings are particularly relevant in light of the overdose crisis.Plain Language Summary TitleEnhancing Integrated Treatment Programs for Severe Concurrent Substance Use and Mental Disorders: Insights on Overdose from the ROAR CANADA Project.; OBJECTIVE: This paper presents the methods and initial findings from the Reducing Overdose and Relapse: Concurrent Attention to Neuropsychiatric Ailments and Drug Addiction (ROAR CANADA) project. ROAR CANADA is a longitudinal study of individuals with severe substance use and severe mental disorders (concurrent or dual disorders). The study included patients from two BC treatment centers, Red Fish Healing Centre and Heartwood Centre, as well as a treatment unit at St. Joseph's in Ontario, all of which use a comprehensive integrated treatment program. Our initial analysis focused on identifying transdiagnostic risk factors for drug overdose. METHOD: We assessed sociodemographic factors, trauma history, and impulsivity as part of a broader longitudinal evaluation. Using bivariate analysis and logistic and linear regression models, we examined the relationship between these factors and overdose history. RESULTS: Out of 450 participants, 291 (64.7%) reported having experienced one or more overdoses, with an average of 7.6 overdoses per person. Patients at Red Fish had a slightly higher average (8.5 overdoses) and prevalence (74.5%) of overdoses. High rates of adverse childhood events, lifetime trauma, and impulsivity were observed. However, only lifetime trauma was consistently associated with overdose risk across all treatment centers. Impulsivity was linked to overdose risk in some locations but not across the entire sample. CONCLUSIONS: The findings underscore the importance of trauma-informed care in treating individuals with severe concurrent substance use and severe mental disorders.; eng
AD - Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. RINGGOLD: 12358; BC Mental Health and Substance Use Services Research Institute, Provincial Health Services Authority, Vancouver, British Columbia, Canada. RINGGOLD: 60299; Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton/McMaster University, Hamilton, Ontario, Canada.; Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada. RINGGOLD: 3710
AN - 39901488
BT - Can J Psychiatry
C5 - Opioids & Substance Use
CP - 8
DA - Aug
DO - 10.1177/07067437251315516
DP - NLM
ET - 20250203
IS - 8
JF - Can J Psychiatry
LA - eng
N2 - ObjectiveThis paper summarizes methods and initial overdose-related results from the Reducing Overdose and Relapse: Concurrent Attention to Neuropsychiatric Ailments and Drug Addiction (ROAR CANADA) project. ROAR CANADA is a longitudinal observational study of individuals with severe concurrent substance use and mental disorders (also called dual disorders or dual diagnosis). The study sampled patients treated at two tertiary treatment centres in British Columbia, Red Fish Healing Centre and Heartwood Centre, along with a concurrent treatment unit at St. Joseph's in Ontario. These facilities have implemented evidence-based integrated treatment programs. Our first analysis explores selected baseline characteristics as potential risk factors for drug overdose in this population.MethodSociodemographic factors, trauma history, and impulsivity were part of a more comprehensive longitudinal assessment. In this first investigation, we use bivariate analysis and logistic and linear regression modelling to examine these variables in relation to overdose history.ResultsOverall, 291 of 450 participants (64.7%) reported a history of ≥1 overdose. Across the three centres, patients had a lifetime average of 7.6 (SD = 12.9) overdoses. The prevalence and mean number of overdoses were somewhat higher among Red Fish patients (74.5% and 8.5, respectively). Adverse childhood events, lifetime trauma history, and impulsivity were all high, but only lifetime trauma history emerged as significantly associated with overdose across all treatment centres. Impulsivity indicators were selectively associated with overdose by site, but not consistently within the overall sample.ConclusionsThese results highlight the importance of prioritizing trauma-informed care in the treatment of individuals with severe concurrent substance use and mental disorders, who are at high risk of overdose. The integration of trauma treatment into existing programs may enhance patient outcomes and contribute to the ongoing evolution of effective care strategies for this complex population. These findings are particularly relevant in light of the overdose crisis.Plain Language Summary TitleEnhancing Integrated Treatment Programs for Severe Concurrent Substance Use and Mental Disorders: Insights on Overdose from the ROAR CANADA Project.; OBJECTIVE: This paper presents the methods and initial findings from the Reducing Overdose and Relapse: Concurrent Attention to Neuropsychiatric Ailments and Drug Addiction (ROAR CANADA) project. ROAR CANADA is a longitudinal study of individuals with severe substance use and severe mental disorders (concurrent or dual disorders). The study included patients from two BC treatment centers, Red Fish Healing Centre and Heartwood Centre, as well as a treatment unit at St. Joseph's in Ontario, all of which use a comprehensive integrated treatment program. Our initial analysis focused on identifying transdiagnostic risk factors for drug overdose. METHOD: We assessed sociodemographic factors, trauma history, and impulsivity as part of a broader longitudinal evaluation. Using bivariate analysis and logistic and linear regression models, we examined the relationship between these factors and overdose history. RESULTS: Out of 450 participants, 291 (64.7%) reported having experienced one or more overdoses, with an average of 7.6 overdoses per person. Patients at Red Fish had a slightly higher average (8.5 overdoses) and prevalence (74.5%) of overdoses. High rates of adverse childhood events, lifetime trauma, and impulsivity were observed. However, only lifetime trauma was consistently associated with overdose risk across all treatment centers. Impulsivity was linked to overdose risk in some locations but not across the entire sample. CONCLUSIONS: The findings underscore the importance of trauma-informed care in treating individuals with severe concurrent substance use and severe mental disorders.; eng
PY - 2025
SN - 0706-7437 (Print); 0706-7437
SP - 600
EP - 610+
ST - Enhancing Integrated Treatment Programs for Severe Concurrent Substance Use and Mental Disorders: Insights on Overdose from the ROAR CANADA Project
T1 - Enhancing Integrated Treatment Programs for Severe Concurrent Substance Use and Mental Disorders: Insights on Overdose from the ROAR CANADA Project
T2 - Can J Psychiatry
TI - Enhancing Integrated Treatment Programs for Severe Concurrent Substance Use and Mental Disorders: Insights on Overdose from the ROAR CANADA Project
U1 - Opioids & Substance Use
U3 - 10.1177/07067437251315516
VL - 70
VO - 0706-7437 (Print); 0706-7437
Y1 - 2025
ER -