Addictions Services

What we heard:

Currently, access to addictions services is voluntary, respecting the fact the individual must recognize a
need for treatment. While this approach works for many people, it is difficult for family, friends and the
community when the individual does not agree to treatment. More can be done to provide support and
engage in efforts to encourage those who need treatment to receive treatment.
Access to opiate substitution treatment should be broadened. Those on evidence-based substitution
treatment regimes should also have access to medical, pharmaceutical, and psychosocial supports. The
alarming prevalence of opiate use, particularly among young Nova Scotians, suggests that the appropriate
infrastructure to support treatment (generally methadone) programs should be available provincially.
This will require the development of standards, laboratory testing of urines, recruitment and training in
core competencies for health practitioners in primary care so they can undertake prescribing, managing
and ongoing care of individuals that have been stabilized in supported programs.

The following challenges specific to addictions services access and intervention have been identified:

• Chronic shortage of withdrawal management services;
• Shortage of intensive residential and inpatient rehabilitation programs;
• Lack of supportive housing using a recovery model;
38 Report & Recommendations of the Mental Health and Addictions Strategy Advisory Committee
• High recidivism to withdrawal management; and
• Limited access to methadone treatment due to low numbers of practitioners competent
in methadone management, lack of infrastructure to manage and monitor adherence to
treatment, lack of community-based treatment and lack of funding.

These challenges have resulted in the following problems:

• Without appropriate access to withdrawal management and recovery care, individuals
have lost family, housing, employment, and freedom due to incarceration. They have
experienced deterioration in physical health. This all has a detrimental impact on the
well-being of communities. The economic cost to health care programs, and the social
cost to communities and individuals are increased when individuals are unable to be
financially independent or are incarcerated.
• Without access to methadone treatment there is a higher chance of overdose and death.
When people are stable on methadone, other health issues like Hepatitis C can be
treated in a timely manner, avoiding subsequent serious medical consequences.

Recommendations :

2.6-1 Reconfigure addictions inpatient beds for withdrawal management, opiate stabilization
and structured treatment according to evidence and best practice, utilizing alternative
community-based approaches where possible.
2.6-2 Ensure that withdrawal management services for youth are available for management
of addictions and concurrent (mental health and addictions) disorders. Ensure separate
adult access to treatment for concurrent disorders.
2.6-3 Support the development of community-based supportive care for mental health and
addictions within specific cultural communities in the province, and offer on-site care to
populations that cannot, for a variety of reasons, access that care in clinical settings.
2.6-4 Increase access to evidence-based opiate substitution treatment.

We end our report with a caution: Nova Scotia cannot afford the cost of not acting on our recommendations.
The current and future well-being of all Nova Scotians and our communities is at stake.

See full report here : http://www.gov.ns.ca/health/mhs/reports/MHAS_2012_Full.pdf