DRUG PROBLEM NOVA SCOTIA'S 'DIRTY LITTLE SECRET'

Bureaucracy Leaves Addicts High And Dry, Lawyer Says

Drug addiction and a lack of treatment facilities are Nova Scotia's "dirty
little secret," a Nova Scotia Legal Aid lawyer says.

"If the numbers and the pain were known, and if there were any way of
measuring the money spent in other parts of the health-care system for
problems which I would regard as much less serious, then I believe most
people would be angry," said John Black, who deals with addicts regularly
while handling cell matters at Halifax provincial court.

From his perspective, one of the difficulties dealing with drug-related
crime is simple bureaucracy.

"An individual (addict) can't shop in one place," he said. The police and
courts often view the drug scene as a health, addiction or mental health
problem, while the health system tends to view it as a judicial one.

"There's really very little co-ordination between the two," Mr. Black said.

"Addicts are human beings and I regard it as a health issue that a liberal
society ought to address."

There are no drug programs around, except those in prison, that are not
voluntary, he said.

"Forcing people into drug programs would trample on their civil rights,"
Mr. Black said. "We're talking about medical treatment for which consent is
required. It's really that simple."

Drug addiction is difficult to conquer and it can't be done without a great
deal of commitment, he said.

"The nature of the beast is that the desire and commitment to get and stay
clean varies among drug users," he said.

"There are cycles and events in an addict's life that trigger a wish to get
clean. The same applies to those who slip back."

Mr. Black said being arrested is one of those events that will cause
addicts to take a serious look at themselves and their habit and cause them
to want to do something about it.

Ordinary citizens, not the government, bear the costs of crime committed by
addicts.

"It's certainly an argument for making more resources available to treat
addicts," he said.

Mr. Black said he often sees people arrested and brought to court who are
under the influence of drugs or in the beginning stages of withdrawal.

"The pain is evident and I really wonder whether the people who make the
decisions about how the Department of Health's budget is carved up have any
awareness of the needs of these addicts," he said.

And the same applies to those dealing with mental health issues, Mr. Black
said.

He said several privately operated treatment facilities in the province are
playing a valuable role in treating all types of addictions. They operate
outside the umbrella of the Health Department and are organized by people
who are able and dedicated, he said.

The facilities get by on very limited budgets but provide addiction
treatment and in-house, long-term programs in which clients are supervised.
There is zero tolerance for breaking the rules.

"They are in considerable demand."

Private facilities are providing a service that the Health Department
doesn't, he said.

"They offer an alternative to jail for many of my clients," Mr. Black said.
"But before being accepted, they have to persuade operators of these
private facilities that they are sincere and committed."

Brian Wilbur, director of addiction services for the Health Department,
said the province spends about $25 million a year on addiction services.

"We have a great network of services here in Nova Scotia," Mr. Wilbur said,
referring to three methadone clinics, eight major treatment facilities and
33 satellite offices in the province.

He said each of the treatment facilities has a three-day withdrawal
management program to try to dry out drug users, "to get them over the hump
and then get them into some sort of long-term treatment program," Mr.
Wilbur said.

"You can keep drying people out over and over again. The key element is
connecting them into a treatment program.

"While they are motivated, you want to connect them with good, solid
programming."

Mr. Wilbur said the department offers structured treatment programs
throughout the province.

"It could be a five-day program, 10 days or a weekend program," he said.

"Whatever a group of clients need."

Treating an addict may require several attempts, Mr. Wilbur said.

"That's part and parcel of the disease," he said.

"When people want to get help, they don't all go into detox. Only about 30
per cent of our addict population need a detox bed.

"If someone calls up and there is no bed available, they may be encouraged
to call back the next day.

"We want to maintain the contact with them so that we can get them in as
quickly as possible."

Capital Health could use almost four times the number of detox beds as it
has now, said Tom Payette, director of addiction services for the Capital
district health authority.

"We have 15 beds for a population of 400,000," he said. "The standard tends
to be 11 or 12 beds for 100,000."

There are also 14 beds for the Choices program for adolescents.

Some people discharged from detox are referred to the outpatient Community
Oriented Recovery Environment (CORE) based at the Nova Scotia Hospital.

The Monday-to-Friday program, which looks at what drugs do to an addict's
life, family, work and physical and psychological health, serves as many as
40 patients a day.

There are 10 beds for CORE participants who live too far away to commute
each day or "who need some kind of escape from their present environment,
whether it be a crack house or . . . a spouse who may be using," Mr.
Payette said.

There are programs similar to CORE across the province that also look at
techniques to help people reduce drug use or to live drug-free.

"With CORE being open-ended the way it is," Mr. Wilbur said, people can
readily get into programs.

"We increased services two years ago across the province and can now focus
on making sure women and youth get better access to our services.

Counsellors are seeing more problem gamblers but alcohol abuse is still the
biggest addiction problem, Mr. Wilbur said.