Addicts must sit and wait
Published Tuesday August 19th, 2008
‘It should be a health-care issue and not a criminal issue'
They say a watched pot never boils, but imagine how slowly time crawls when you're suffering from withdrawal symptoms while waiting weeks, even months, for desperately needed drug-treatment services.
Wait times and wait-lists are a fact of life for those seeking drug treatment.
That's the way it is in every facet of the health-care system and addiction services aren't any different, said Gordon Skead, manager of addiction services for River Valley Health.
"Everybody's busy ... We admit (patients) five days a week," he said, noting there's a never-ending demand for all of the programs offered by River Valley Health's addiction services branch.
This region's addiction services branch offers methadone treatment, counselling and detox programs.
The wait-lists for the latter two programs are shorter than for methadone, Skead said, because methadone is a much longer-term treatment course, as patients can be on methadone for years.
Opiate addicts seeking treatment through the methadone program offered by addiction services can wait a couple of days or up to seven months, Skead said.
The wait time depends on the addict's specific circumstances.
For example, a pregnant woman addicted to opiates will get into the methadone program faster than other addicts.
The reality is demand for treatment exceeds the availability of services, Skead said.
"You're always going to have a wait-list," he said.
Skead said more funding and resources for addiction services would likely help to curb wait times.
Provincial court Judge Graydon Nicholas, who formerly sat in Woodstock court, sees addicts in his court every day.
He knows there are long wait lists for drug-treatment programs such as methadone, he said, and he wishes services were more readily available to people who genuinely want to recover.
Better availability of treatment – in terms of timing and location – is important not only for the addict, Nicholas said, but for the community as a whole.
"Because it's crime prevention," he said.
The number of shoplifters who appear in court as a result of addictions is innumerable, Nicholas said, and the number of robberies has spiked in the capital region in recent years due to drug addiction.
"They've all been because of drugs," he said of the increasing number of robberies.
The faster an addict can access drug treatment, the judge said, the less likely he or she will resort to crime to support a drug habit.
Another treatment course can be in-patient rehab programs. The province's two rehab facilities are in Saint John and Campbellton. Addicts referred by counsellors for rehab treatment go to one of those two facilities.
Kelly Evans, manager of addiction services for Saint John's health authority, said the wait-list scheme for rehab at the Saint John facility, called Ridgewood, is more complex.
"The wait for rehab is not very long," said Nancy Hicks, nursing manager with addiction services in Saint John.
Ridgewood operates separate, rotating rehab programs for men and women, Hicks said, and the wait depends on where they are in the rotation.
There are usually two men's programs for every one women's program due to demand, so if a female addict's name is put on the rehab list while a women's program is already underway, she may have to wait eight to 10 weeks.
But the wait for rehab is usually about two or three weeks, she said.
Those in-patient, group rehab programs generally run for three or four weeks.
Evans said its methadone program has 150 patients now and operates at capacity, with anywhere from 70 to 75 people on the waiting list at any given time.
Margaret Dykeman is the manager of the University of New Brunswick's community health clinic, which runs its own methadone program. She said drug addiction is a much bigger issue than most New Brunswickers realize.
Until that changes, she said, the problem will continue to overwhelm the system.
"Until we understand that we are in a crisis situation and that persons who use (drugs) have very complex needs, I do not believe that we are going to make any great amount of headway with this health issue," Dykeman said.
The UNB clinic has about 70 patients in its methadone program that come from all over New Brunswick.
Some are street-level addicts, but others are people who are struggling to deal with chronic pain and a resulting addiction.
"To date, we are still treating it as a more important correctional issue than we are as a health issue that we need to treat like any other health issue," Dykeman said.
Nicholas agreed it's a health-care issue as well, especially when it comes to mental health.
"The addiction surfaces because there's a deep-rooted problem," he said.
"Drugs are an escape ... ‘Let me get away from this pain.'"
Treating the psychological factors is as important as treating the physical aspects of addiction, the judge said.
Edward Derrah is a defence lawyer with Legal Aid New Brunswick who frequently deals with drug addicts who have run afoul of the law. He said if more government funding and resources were dedicated to drug treatment instead of enforcement, addictions and drug-related crime would probably decrease.
"I have to believe that's true," he said. "It should be a health-care issue and not a criminal issue."
He said he's seen a lot of defendants who said they ended up in court because they fell off the wagon because they had to wait so long for treatment.
"I hear very frequently, ‘I've been on the waiting list for months,'" Derrah said.
However, he said he's doubtful all of those claims are true. He said some addicts who find themselves before the courts offer excuses that might not be completely accurate.
"Some of these people are just never going to quit," Derrah said, but there are also those who genuinely want to quit and want help but are forced to wait.
He said another factor that likely impacts some addicts' wait times is that many of them live transient lifestyles and are so poor that they can't afford a phone or even a stable home.
It's likely that when some addicts' names come up in the wait-list rotation for treatment, Derrah said, officials might be unable to track them down.
Skead said communication with some clients can be a challenge.
"We do try a number of attempts by phone and a number of attempts by letter," he said.
Once a counsellor makes contact with a client, Skead said, there tends to be some strong communication between them.
He said one key to continued contact is treating addicts with respect.
"These are people ... and we try and treat them like people," he said.
That respect keeps patients coming back and makes them want to stay in touch, he said.
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