How Canada’s Rehab Centres are Failing Drug Users
Canadians are waiting months to get into government treatment centres, new data shows.
Even though she's next on the list for a bed at one of Manitoba's best mental health and drug treatment facilities, Destiny Bohemier has been waiting from a hospital in Brandon, Manitoba for more than 10 months. Her friends tried to crowdfund enough money to pay for a private facility that would let her in right away, but it was unsuccessful.
Bohemier has spent many of her 26 years addicted to drugs and suffers from psychological and eating disorders. She was admitted to the Brandon hospital after her latest suicide attempt. At the height of her addiction, she was buying fentanyl patches off the street; shooting and chewing them. Countless overdoses have almost killed her.
On methadone to curb her opioid cravings for a year now, Bohemier feels confident she can fully recover if she gets into the long-term residential program in Manitoba. "I'm hoping it will be the answer I've been waiting for," Bohemier said over the phone from the hospital.
"Yet I'm also scared, because it's my last chance."
VICE News obtained new data that stitches together a national picture of government-funded rehab wait times, revealing how long Canadians like Bohemier struggling with addictions can be kept waiting for life saving treatment. Wait time varies widely, and in some places, it's getting worse.
In the absence of any national tracking, we asked every provincial and territorial health ministry for data from 2012 to present for residential facilities they fund that treat opioid addictions. Depending on the jurisdiction, opioid addicts are waiting anywhere from a couple weeks to more than two months.
But this is just an average—the reality for many people can drag on much longer, depending on where they are and their specific treatment needs.
Manitoba, where Bohemier is, reports the longest average wait times in the country: from 52 days in 2012 and 2013 to 60.6 days over the last year. The province has promised to improve the situation, and created a fentanyl task force in January with $500,000.
As the opioid crisis leaves a trail of devastation, with thousands of Canadians expected to fatally overdose this year, the issue of affordable and reliable treatment is ever more urgent. Even as governments slowly unveil their strategies to combat the crisis, there has yet to be much action on improving access to treatment.
Some places, such as Nunavut, do not track wait times of the facilities they fund. A spokesperson for the Yukon health ministry refused to provide any data because the department was in the middle of moving. And Prince Edward Island stopped responding to requests.
The Northwest Territories refers people with opioid addictions to Alberta or British Columbia because it has no in-patient facilities that treat the condition, a ministry spokesperson told VICE News. The Quebec health ministry said it doesn't keep centralized statistics on the issue.
And because healthcare in Canada is not run by the federal government, the way wait times are tracked varies across provinces and territories. For instance, Saskatchewan tracks average wait times by weeks, and other provinces track by days. Things are more complicated in Nova Scotia, where the average is based on the number of days someone will wait in nine out of 10 cases. From 2014 to 2015, that average was 19.7 days. The following year, it was 14.9 days.
The only addictions treatment facilities funded by the federal health ministry are those for First Nations peoples. There are 43 such facilities. But the ministry does not monitor the wait times for any of these places, a department spokesperson stated in an email, nor how long people have to wait when they are sent for treatment in other parts of the country because the local facilities are full.
On the other side of the country, in Port Coquitlam, British Columbia, Veronica Staddon is grieving the loss of her daughter, Gwynevere. She died this August at the age of 16 after she took a fatal hit of fentanyl in a Starbucks bathroom.
"She was my little buddy," Staddon said over text message.
BC is on track to see more than 800 people die of opioid overdoses this year. The province became the first in Canada to declare a public health emergency over the matter earlier this year, prompting authorities to release overdose data in real-time. More than three years ago, the premier campaigned on a promise to add 500 new addictions treatment beds by 2017, but that hasn't happened yet.
Like Bohemier, Staddon couldn't afford tens of thousands of dollars a month on private drug rehab. The family contacted a local treatment centre for youth funded by the province, but it didn't have an official wait list.
"You call every day to see if there is room. It is ridiculous," said Staddon.
According to September statistics provided by the BC ministry of health to VICE News, there are 203 beds for children and youth with mental health and substance abuse issues available in three health districts. However internal documents obtained from the NDP by the CBC for that month show just 89 "youth substance use" beds.
The ministry told VICE News that wait times for youth residential treatment range on average from two to six weeks. Adults can be kept waiting anywhere from 2 weeks to six months.
In October, BC Premier Christy Clark struck a new opioid research group, led by Dr. Evan Wood, who recently admitted there are faults in the addictions services available across the province.
Wood told reporters that many drug users fall through the cracks and relapse after undergoing detox unless they are immediately admitted to rehabilitation, because their tolerance has weakened and the risk of fatal overdose greatly increases. Another major issue is that most facilities require a doctor's referral, something that can add weeks to the wait.
Eventually, Staddon and Gwynevere gave up calling the facility. The teen tried to stop using on her own. She showed progress for a couple weeks when she enrolled in a detox centre—which also have their own waitlists—but it was impossible to get away from the drugs. Even when she picked up her prescription for suboxone, a medication like methadone that helps quell withdrawal symptoms, Staddon says there were dealers lurking outside the pharmacy doors.
"Or they will zip over and come right in front of the parents' house or into the backyard," Staddon said. "Gwynevere wanted to quit using willpower, but it was just so prevalent everywhere she went."
Gwynevere's boyfriend, Nick Jansen, also struggled with a fentanyl addiction since first trying it on his 16th birthday. He was in treatment the day she died. Five months before that, his older brother Brandon died of a fentanyl overdose in a treatment centre at the age of 20.
"At his funeral I was thinking, this could easily be my funeral, my urn," Jansen, now 19, said in an interview. "It killed me thinking about that."
His family could afford to send him—and his brother—to costly treatment centres, and avoid the lack of spaces and wait times in government facilities. They spent hundreds of thousands of dollars and for Jansen it paid off.
He's hasn't used since Canada Day, and now he and his mother plan to open their own private drug treatment centre this January, and leave at least two beds free for people who can't afford it and are stuck on a government wait list.
"I'm leaning toward calling it something a little corny, a little cheesy like Leap of Freedom, because really it's so hard to get into a treatment centre," he said. "We've been getting phone calls daily from people who are looking for treatment, places that will actually work."
Ontario, the most populous province in the country, reports the second highest wait times, after Manitoba. The average waits have remained steady in recent years: 43 days in 2012 and 2013 to 42 days over the last year. Ontario also has the most comprehensive and up-to-date monitoring system of wait times with a dedicated unit in the health ministry that that keeps a database of every in-patient treatment centre.
Last month, after years of outcry from health and drug policy experts, Ontario health minister Eric Hoskins announced a new strategy that allocates $17 million a year for chronic pain clinics across the province. It doesn't address wait times or improving access to in-patient addictions treatment.
Dr. Mark Ujjainwalla, an addictions specialist who has practiced for 30 years in Ottawa, called the plan "totally useless."
"Nothing changes as usual," he told VICE News. "It's this epidemic, yet no one is taking it seriously."
It's easy for him to prescribe methadone at his clinic, but it's almost impossible for patients to find long-term treatment that will target the root cause of the addiction.
He recently tried calling seven places looking for residential treatment for a 23-year-old woman who has hepatitis C and is addicted to crack and fentanyl. He spent most of the time on hold, and was told nothing was available for her, or that she'd have to wait at least one month.
He used to make these calls all the time, but he's come to the conclusion that without hundreds of thousands of dollars to spare, there's really nothing in Ontario in the way of publicly-funded treatment that will guide someone from detox to a full recovery.
"In Ottawa, we don't have a medical detox that is available," he said. So drug users are expected to go through detox from street drugs without the oversight of a doctor or nurse, and without interventions to replace the cravings, like methadone. "If someone then has a seizure [in detox], they just call an ambulance and bring you to the emergency room. There is no department of addictions in any of the hospitals here."
"In most cases, they put you back on the streets. That's exactly what's happening day in and day out. You either do more drugs, commit more crime, or die," he added.
The Canadian Medical Association recently released a policy paper that criticized the pervasive ad hoc approach to addictions treatment in the country. The group calls for more holistic programs that address both physical, psychological, social and spiritual circumstances.
"Access to addiction treatment is very limited and, when available, is primarily comprised of detox or the substitution treatments with methadone or suboxone," the report states. "As addiction is a primary, chronic disease ... treatment must address all those areas rather than just one or another."
Unless the provincial and federal health departments commit to overhauling addictions treatment, something that would require billions of dollars, Ujjainwalla said one solution would be for Ontario to pay for people to get private addictions treatment in the US, which for him, is the "gold standard."
"The US is lightyears ahead of us in terms of the treatment of opioid-dependent individuals, the treatment of addiction in general," he said. "If you can't get that treatment in Ontario, the government should pay for your treatment where it is readily available."
With files from Michael Robinson
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