For most of her life, Oma Feldinger struggled with alcohol. She felt like she had exhausted all her treatment options – until she found the Rapid Access Addiction Medicine (RAAM) Clinic at St. Joseph’s Health Centre and everything changed.

“Nobody was getting to the root of the problem, of what was driving my addiction,” she said. “As soon as I connected with Dr. Melissa Yu and this clinic, I felt seen. I felt like I could do this. She understood how my anxiety affected my drinking. It’s been a blessing.”

Staff and physicians who work in the Rapid Access Addiction Medicine (RAAM) Clinic, and/or the Addictions Consultation Clinic at St. Joseph’s provide low-barrier care to those in need. (Photo by Eduardo Lima)

Both the St. Joseph’s and St. Michael’s Hospital sites at Unity Health Toronto offer RAAM Clinic services, which are low-barrier, drop-in clinics available that provide substance use-related care. They aim to reduce lengthy intake processes and waiting lists and importantly do not include a requirement to be abstinent. The clinic team work with each patient to come up with a plan to address their goals, including medication and psychosocial interventions. Patients don’t need to live in a certain catchment or make an appointment – they can just come in.

“We just meet patients where they are,” says Dr. Yu, a family medicine physician who works at both the St. Joseph’s and St. Michael’s RAAM clinics.

“We work with whatever stage of change they need. If a patient’s goal is to reduce or understand their substance use, we can provide counseling and support.”

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A study published in 2023 in JAMA Network Open suggests that RAAM clinics helped reduce Emergency Department visits, hospitalizations and mortality in patients living with opioid addiction. The low-barrier model works well for patients living with addiction because it’s not rigid, says Dr. Anita Srivastava, Medical Director of Mental Health and Addictions at Unity Health.

“Often when people are using substances it can be difficult to plan for scheduled appointments: we see patients in a low barrier, walk in model for when they are ready to access care,” says Dr. Srivastava. “For our RAAM clinics, there isn’t that rigidity. Nobody is turned away.”

Multidisciplinary approach key to success

Dr. Eric Solway is a family physician at St. Joseph’s who has worked at the RAAM clinic for more than 25 years. The name, model of care, and approach has changed over the years, but the principle of low-barrier support has remained. Now, he says, there are more than 80 locations throughout the province offering rapid access addiction medicine support.

Having this service available at both Unity Health acute care sites is also important to improve access to addictions care, says Dr. Srivastava.

“It should be available in patients’ medical homes,” she says. “St. Michael’s and St. Joseph’s are geographically far apart. They service different populations. They’re both high-needs areas. It’s important that this care is accessible in different parts of the city and anyone can drop in.”

How to access our RAAM Clinics at Unity Health:

At St. Joseph’s:

When? Every Wednesday from 1 p.m. to 4 p.m. (last registration 3:30 p.m.) as well as Tuesday and Thursday from 10 a.m. to 11:30 a.m.

Where? Register at Outpatient Mental Health Services, located on the 5th Floor, Morrow Wing.

At St. Michael’s:

When? Monday to Friday, 9 a.m. to 11 a.m.

Where? 17 Cardinal Carter Wing

For more information, please visit our Mental Health and Addictions page.

At Unity Health, Mental Health and Addictions nurses, support workers and administrative staff work with physicians from Family and Community Medicine to provide holistic care for patients living with any type of addiction at both RAAM clinics. Patients come from Withdrawal Management Services, inpatient units, community care providers and agencies, and importantly, the ED, helping to reduce pressures by giving patients access to the care they need it, where they need it.

The multidisciplinary team approach is key to the model’s success, says Dr. Erin Lurie, a family physician who works at the St. Michael’s RAAM.

The RAAM team at St. Michael’s is a multidisciplinary group, which benefits patients, staff and learners. (Photo: Katie Cooper)

“Patients have access to the resources and specialties of all these people,” Dr. Lurie says. “And for our learners, it’s a really amazing educational opportunity because the patients have so much to teach.”

In the spirit of collaboration, the RAAM Clinic at St. Joseph’s relocated to the Mental Health and Addictions Medicine outpatient area of the hospital last year.

“The offices have been newly renovated to meet our unique needs,” Dr. Solway says. “We have more space for learners as well.”

Victor Rodrigues is a community addiction worker in the RAAM Clinic at St. Joseph’s. He is often the first face patients see when they come through the doors. For him, this type of a clinic exemplifies Unity Health’s mission to create the best care experiences.

“We want to make sure that if they need to, patients will come back to us,” he says. “We want them to feel comfortable and know that they’re not alone.”

In Feldinger’s work with Dr. Yu and the RAAM Clinic, this has been the exact sentiment.

“This is the place you can go when you feel all else has failed,” she says.

“I’ve hit that point in the past where you just feel like you’re done. This clinic changed my life. Just pop in. Somebody will help you.”

By Ana Gajic

St. Joseph’s Health Centre photos by Eduardo Lima, St. Michael’s Hospital photos by Katie Cooper