Nova Scotia Health says there is hope as overnight detox service is suspended in Sydney

When Nova Scotia Health suspended its overnight detox beds at Cape Breton Regional Hospital in July, it said it needed two weeks to find another doctor to oversee the inpatient service.

But it’s been almost four months and people who need help recovering from substance abuse can’t wait any longer, says Blair Kassoff, a retired attorney, social worker and addiction treatment advocate.

“The thing with addictions, when that light comes on for a while and someone says, ‘I need help,’ they need to be able to get it right away, not ‘here’s an appointment for six weeks,’ because that person’s probably not going to come,” Kassouf said.

Dr. David Martel, the province’s medical lead on addictions treatment, said it is difficult to recruit new doctors, especially for the specialty service.

“Some physicians want to make this a career or do this kind of additional work in addition to their busy practice,” he said.

Meanwhile, Sydney Hospital is handling most patients through its outpatient day program and those with severe withdrawal may be referred to the emergency department, Martel said.

“All parts of the health system are able to help people deal with those symptoms,” he said. “This should not be a specialty where only a small part of the health system has expertise.”

Martel said the regional hospital’s “pivot” of outpatient services has worked “incredibly well,” with about 80 percent of patients being treated in the day program at the hospital’s Recovery Support Center.

At the same time, Sydney’s emergency departments and other hospital wards face the same challenge of capacity constraints as other facilities across the province, Martel said.

However, physician recruitment is ongoing and Martel said he hopes to bring a doctor on board for the inpatient detox service within a few months.

Kassouf said referring people with severe withdrawal symptoms to the emergency department is not good enough.

ERs are already overburdened, she said, and people recovering from substance abuse need special care to deal with symptoms, which can include projectile vomiting and agitation, which can bother other patients.

“Going through a serious relapse is not like being admitted for a broken leg,” Kassouf said.

“There are a lot of things involved with it and there are a lot of social factors as well.

“Many times their family is in chaos. Their work and/or their life is in chaos. As far as what’s shown to the public, they’ve been keeping it together, but they’re falling apart in their lives and it’s not OK to say, OK, ‘Stick them in the hallway of the ER.’

ER a ‘dumping ground’

Kassouf said some people with addictions won’t go to the ER, and those who do may not have to wait hours for an appointment.

He would return to substance abuse to ease withdrawal symptoms, he said.

“I don’t know if anyone actually consulted our ER staff about whether this was a good idea.

“It’s a great dumping ground for all the social problems in this community. Send them to the ER, they’ll fix it, and it’s not fair to the staff there or the people who are coming in the door with a heart attack or something.”

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