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Meta:Phi LogoMentoring, Education, and Clinical Tools for Addiction: Primary Care–Hospital Integration (META:PHI) is a collaborative project to create new care pathways for addiction. Originally funded by ARTIC and implemented in seven sites in Ontario, META:PHI is now being rolled out in Toronto with the support of the Toronto Central LHIN.

RAAM Clinic Schedule

RAAM Clinic Patient Pamphlets:

St. Joseph’s Health Centre Rapid Access Clinic
30 The Queensway, Ground Floor (Family Medicine)
416-530-6486 ext. 3969
Open Tuesdays and Thursdays 10:00–11:30

St. Michael’s Hospital Rapid Access Clinic
30 Bond St., 17th Floor, Cardinal Carter Wing
Open Mondays, Wednesdays, and Fridays 9:00–11:00

Women’s College Hospital Rapid Access Addiction Medicine Clinic
76 Grenville St., 3rd Floor
416-323-7559 ext. 6.
Open Mondays, Tuesdays, and Thursday 10:00–12:00

- For Pregnant Patients Only - St. James Town Health Centre
410 Sherbourne St., 1st Floor
Open Wednesdays 12:00 – 4:00


Toronto Western Hospital Rapid Access Addiction Medicine Clinic
399 Bathurst St., 1st Floor, West Wing (WW 1-414)
416-603-2581 (main switchboard)
Open Mondays and Wednesdays 9:00–11:00

Sunnybrook Health Sciences Centre Rapid Access Addiction Medicine Clinic
2075 Bayview Ave., Room B6 34
416-480-6100 ext. 6736
Open Wednesdays 2:00–4:00

Michael Garron Hospital Rapid Access Addiction Medicine Clinic
825 Coxwell Ave., 1st Floor, Central Registration
416-461-8272 (main switchboard)
Open Tuesdays and Fridays 9:00–11:00


The purpose of META:PHI is to integrate addiction care provided by the emergency department, hospital units, addiction medicine specialists, family doctors, and community programs, allowing patients to move smoothly between these services. Clinical education, tools, and ongoing support are provided to health care professionals working in these settings to ensure that patients are receiving the best possible care.

Meta:Phi Flow

In the META:PHI model, patients presenting to any health care setting (emergency department, hospital, primary care) with an alcohol- or opioid-related condition receive highly effective, evidence-based treatment, and upon discharge are referred to a rapid access addiction medicine (RAAM) clinic, which they can attend without a booked appointment or formal referral note. RAAM clinics also accept self-referrals, as well as referrals from withdrawal management, community services, and the criminal justice system.

At the RAAM clinic, the addiction clinical team immediately provides counselling, prescribes appropriate addiction medications (such as buprenorphine, naltrexone, or acamprosate), and connects patients to community treatment programs. Once patients are stabilized, they are referred back to primary care for long-term follow-up; the clinical team provides ongoing support by being available to family physicians for re-assessments, consultations, and advice about addiction care. In this model, addiction specialists, hospital staff, family doctors, and community service agents work together to provide seamless and accessible care to patients with substance use disorders.

The result is a fully integrated system in which patients receive evidence-based care at every step. 

With the support of the Adopting Research to Improve Care program (a joint initiative of CAHO and HQO), the META:PHI care pathway has been successfully rolled out in London, Newmarket, Ottawa, Owen Sound, Sarnia, St. Catharines, and Sudbury. Currently, the META:PHI team is working with the Toronto Central Local Health Integration Network to spread the care pathway throughout Toronto.


Our Team

Program Lead
Dr. Meldon Kahan MD CCFP FRCPC is currently an Associate Professor in the Department of Family Medicine at the University of Toronto, and Medical Director of the Substance Use Service at Women's College Hospital. Over the years he has written a number of peer-reviewed articles, guidelines, and educational publications on addiction-related topics. His goal for META:PHI is to expand best practices and create integrated care pathways for the management of addictions. His main interests are primary care and addiction, methadone and buprenorphine treatment, medical marijuana, and medical education in addiction).

Clinical Education Lead 
Irene Njoroge RN, BScN, MPH(C) is the Advanced Practice Nurse for the RAAM clinic at Women’s College Hospital, and she is involved with education and capacity building of health care professionals in META:PHI. Irene was the Addiction Nurse Clinician at St. Joseph’s Health Centre Toronto for five years, and has been involved in several addiction-related research and practice initiatives. Her interests include working with marginalized populations to build resiliency; advocacy/creating awareness to reduce stigma around mental illness and addiction; and building capacity in addiction treatment and support within the health professional community.

Program Manager
Kate Hardy (kate.hardy@wchospital.ca) MSW RSW has been working in the Substance Use Service at Women's College Hospital since 2013. She is the primary administrator for META:PHI and oversees all aspects of program implementation. She has a particular interest in criminal justice and mental health.).

Program Coordinator
Sarah Clarke (sarah.clarke@wchospital.caPhD has been involved with various research projects since 2006, and joined the Substance Use Service at Women's College Hospital in 2013. She is overseeing the evaluation of META:PHI and also provides additional administrative support to the site teams).



Emergency Department Tools

Emergency Department Protocols for alcohol- and opioid-related presentations (August 24, 2017)

Clinical Institute Withdrawal Assessment for Alcohol Revised (CIWA-Ar) scale: For emergency department assessment of alcohol withdrawal (5 minutes)

Clinical Opioid Withdrawal scale (COWS): For emergency department assessment of opioid withdrawal

Primary Care Tools

Safe prescribing practices for addictive medications and management of substance use disorders in primary care: A pocket reference for primary care providers (December 19, 2017)

Essential Clinical Skills for Opioid Prescribers

Exceptional Access Program form (fillable PDF): For coverage of naltrexone and acamprosate

Exceptional Access Program naltrexone template (Word document): Naltrexone application with drug information and diagnosis completed

Exceptional Access Program acamprosate template (Word document): Acamprosate application with drug information and diagnosis completed

Opioid Manager: Point-of-care tool based on the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain (distributed through the Michael DeGroote National Pain Centre, McMaster University)

Patient Materials

These guides should be given to patients that have been diagnosed with an alcohol use disorder or an opioid use disorder. They provide information about the causes of addiction, outline treatment options, and offer some suggestions for dealing with cravings in early recovery.

Alcohol Use Disorders: A Guide for Patients (May 17, 2017)

Opioid Use Disorders: A Guide for Patients (May 17, 2017)

Starting Buprenorphine Therapy: A Guide for Patients (January 5, 2018)

Canada’s Low-Risk Drinking Guidelines (Canadian Centre for Substance Abuse)

META:PHI Google Group

The META:PHI Google group is an e-mail forum for health care providers across Ontario to discuss addiction-related clinical issues, policies, and recent articles. E-mail: Sarah Clarke to join the list.


These e-modules provide a concise overview of managing addictions for health care providers.

Primary Care Provider E-Modules

ED Physician E-Modules

ED Nurse E-Modules

ED Counsellor E-Modules

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Location & Contact Information

META:PHI Project Office
Women's College Hospital
76 Grenville Street
3rd floor
Toronto, ON M5S 1B2

Phone: 416-323-7511

Our Publications

  • Fully affiliated with:
  • University of Toronto
  • A member of:
  • Council of Academic Hospitals of Ontario (CAHO)