A partner in service funded by the Mississauga
Halton LHIN Community Concurrent
Disorders Program (CCDP)
Working Together Towards Recovery
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Community Withdrawal Management Services
(CWMS) offers an alternative to residential
withdrawal management for individuals who
can safely withdraw from substances in a
supportive community environment.
Services include pre-withdrawal planning,
acute withdrawal monitoring and post acute
withdrawal support and transitional case
management.
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When a person stops using alcohol and/or
other drugs their body and mind may
experience physical and/or emotional
symptoms.
Withdrawal can be a very uncomfortable
process physically, mentally and emotionally
In some cases, it can feel like a terrible flu
and even cause confusion and delusions.
Others may experience very few symptoms.
Alcohol
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Onset: Generally within 24 – 48 hours of last drink
depending on amount consumed.
Duration: Typically between 3-7 days, can be up to
14 days in severe cases.
Symptoms: May include anxiety, agitation,
sweating, tremor, headache, nausea, vomiting,
abdominal cramps, difficulty sleeping and changes
in blood pressure. In addition some individuals
may experience seizures, hallucinations or delirium
tremens (DT’s).
Opiates (Oxy, Percs, Morphine, Heroin etc.)
 Onset: Generally within 8-24 hours of last use.
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Often will peak within 2-4 days.
Duration: Can last up to 7-10 days for most and 36 weeks for methadone.
Symptoms: May include anxiety, craving, muscle
tension, muscle and bone ache, muscle cramping,
sleep disturbances, sweating, hot and cold flushes,
goose bumps, yawning, nausea, vomiting,
abdominal cramping, diarrhea, palpitations, high
blood pressure and agitation.
Benzodiazepines (Valium, Ativan, Clonazepam,
Diazepam etc.)
 Onset: Within 1-10 days of last use depending on
the drug.
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Duration: Generally 3-6 weeks (or longer)
Symptoms: May include anxiety, headaches, muscle
aching, twitching, cramping, nausea, vomiting,
diarrhea, perceptual changes, feelings of unreality,
seizures, agitation, confusion and psychosis.
Cocaine / Crack
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Onset: Crash within hours of last use.
Duration: Typically 1-4 days after last use
Symptoms: May include cravings, irritability
fatigue, nightmares, difficulty sleeping, increased
appetite, agitation, restlessness and slowed
physical movements.
Cannabis
 Onset: Generally within 1-2 days of last use.
 Duration: Typically between 2-6 days (acute
withdrawal) decreasing after 2-6 weeks. However
can last up to several months. Symptoms: May
include anger, aggression, irritability, anxiety,
nervousness, decrease in appetite, restlessness,
difficulty sleeping, chills, low or depressed mood,
shakiness and sweating.
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Methamphetamines (Crystal Meth)
 Onset: Crash within hours of last use.
 Duration: Typically 1-4 days after last use.
 Symptoms: May include cravings, dysphoria, lack
of pleasure, increased appetite, fatigue, agitation,
anxiety, increased sleep, vivid, unpleasant dreams
and slowing of movement.
If at any time the following symptoms are experienced it is advised
that the individual seek medical attention or go to your local urgent
care center or emergency department.
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Vomiting that won’t let up or vomiting blood
Persistent diarrhea
Difficulty breathing, shortness of breath, or very rapid breathing
Sudden chest pain or severe abdominal pain
Having or had a seizure (a spastic convulsion of the body)
Severe body shakes and chills
Recurring hallucinations
Severe agitation and you can’t calm down
Confusion or disorientation
Feel at risk of self harm or suicidal thoughts. Support is available,
contact COAST Halton @ 1-877-825-9011, the police or 911 if
there is immediate risk.
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Consistent with provincial admission criteria
for CWM
Informed by Best Practices for Concurrent
Disorders
Included a review of existing service models
(ASYR, FourCAST, PAARC)
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Currently intoxicated, with withdrawal or in
crisis related to substance use.
Wanting to stop use of alcohol and/or other
drugs.
Screening and assessment are a critical
element to determine appropriate level and
intensity of service required.
Must meet criteria for CWM admission
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Phone Screening/Intake
CWMS Assessment (face to face)
Individual and Group Withdrawal
Management Counselling
Pre Withdrawal Planning
Withdrawal Monitoring (Acute & Post Acute)
Transitional Case Management
Treatment Assessment and Referral
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RN & RPN available for consultation and
support
Drop In Groups (coming)
◦ Weekday Early Recovery/Support
◦ Weekend Planning/Support
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Family/Support Consultation
Mobile Outreach and Home Withdrawal
available for individuals within the Halton
Region
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Referral Sources:
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CCDP Partners (CMHA –Crisis & Case Management)
ADAPT Intake
ADAPT Active Clients
Physician/Hospitals
Residential Withdrawal Management Services
Self Referral
Other Community Agencies
Withdrawal Management Counsellors/Transitional Case Managers
◦ Shannon Bovie
◦ Priya Chauhan
◦ Jim Spradbrow
Registered Nurse (RN)
◦ Trish Aleve
Registered Practical Nurse (RPN)
◦ Siobbhan Boyter
Program Manager
◦ Carrie Woodcock
Contact Information
CWMS Intake:
Halton Region Local: 905-827-5320
Toll Free: 1-877-517-2237
Fax: 905-847-8959
www.haltonadapt.org
Carrie Woodcock, B.A., Grad Dip. ACW
Program Manager
P: 905-875-9678
E: cwoodcock@haltonadapt.org
Thank You!