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Private, Public, or Free Addiction Treatment? The Pros and Cons of Each

man sitting at table with coffee and stressed

The American Journal of Medicine reports that approximately one in ten people who need help with a substance use disorder will seek out and obtain support.

As hospitalizations due to opioid poisonings increase across Canada, Nova Scotia presents unique challenges.

For example, deaths related to substance use in the eastern zone (Cape Breton, Guysborough, and Antigonish areas) is 15.4 per 100,000 population, a spokesperson for the provincial Department of Health and Wellness told CBC Nova Scotia.

Meanwhile, the national average is 8.4, according to Statistics Canada.

Community Addiction and Mental Health Programming

There are a variety of tools available online, from crisis hotlines to peer support groups and online modules for managing substance use disorders.

While these online programs have an important function, early in the treatment of addiction, a more comprehensive program is required. For example, a program that includes extensive in-person evidence-based therapy such as Dialectical Behaviour Therapy (DBT) and Cognitive Behaviour Therapy (CBT), which focus on regulating emotions and thoughts that lead to addiction.

Public Addiction Treatment Facilities

The Nova Scotia Health Authority has facilities across the province that provide stabilizing treatment for acute detox or acute psychiatric presentations.

After a short length of stay, patients are discharged to waitlists or to community providers.

“There’s no real fulsome continuum of care,” says Cara Vaccarino, the Chief Operating Officer of EHN Canada, the network of addiction treatment and recovery centres that operate Ledgehill.

“That’s where Ledgehill Men’s and Ledgehill Women’s Treatment Centres come in.

“EHN Canada could not agree more with the community stakeholder groups in terms of residential addiction treatment, and all mental health and addiction treatment should be accessible, free of cost to Canadian citizens across the country.”

Cara says EHN has successfully secured provincially-funded residential addiction treatment beds in British Columbia and Ontario, and it’s seeking provincial funds in Nova Scotia for beds as well.

However, until that happens in Nova Scotia, treatment at Ledgehill is paid for by individuals or insurers.

Private Residential Treatment Centres

A private, residential treatment centre is appropriate for individuals with long-term substance use disorders. They provide 24/7 care and intensive treatment regimes in a highly structured environment.

Ledgehill provides seven to nine weeks of treatment and it’s staffed with physicians, psychiatrists, and 24/7 nursing care.

Ledgehill offers a longer stay than individuals would typically see in a publicly-funded residential program.

Cara explains that due to a shortage of resources, patients in the public health care system are stabilized and then discharged without the necessary emphasis on the psychological determinants of addiction.

“Typically, it’s just stabilization and out. And really what happens in that scenario is people don’t get well and they end up coming in and out of the hospital, typically through emergency departments.”

COVID as a Pivotal Moment in the Addiction Treatment Space

Looking at the addiction treatment services landscape, Cara says two major dynamics have surfaced as a result of COVID.

First, many agencies have either shut down completely or scaled back their services.

For example, an in-person training program that addressed the stigma around addiction and mental illness that took place in 11 hospitals in Nova Scotia’s eastern zone is on hold due to COVID.

Second, people who may have less severe issues with substance use disorders “are falling off a cliff” says Cara, because of the social and economic impacts of COVID, especially isolation.

She explains that people are turning to private treatment centres: “they are willing to pay because they’re just so desperate.” Ideally, the treatment should be paid for by the government, but the financial impacts of COVID on the public health care system are overwhelming.

“I wish it was free. I wish everyone could access Ledgehill Men’s and Ledgehill Women’s Treatment Centres in the Maritimes without having to pay at all.”

Until EHN secures provincial funding for beds, Ledgehill remains an effective private option for treating substance use disorders.

“We get the patients and we are responsible to take care of them, which is an absolute privilege to see them get well, and to keep them well.

That really should be on the public purse, but the system is broken, and the financial impacts of COVID on the public health care system are devastating.”

Cara says the only way to address the “revolving door” issue in emergency rooms—where individuals with substance use disorders are treated for their acute symptoms and released after a few days—is therapy and counseling that provides skills that help individuals manage symptoms and relationships related to their addiction.

This often takes place in a sustained way in a residential addiction treatment setting.

We Can Help You

Ledgehill’s two facilities in Annapolis County, Nova Scotia, provide gender-specific treatment for men and women who need to heal in a peaceful, supportive environment free from fear or distraction. If you’d like to learn more about the addiction and mental health treatment programs provided by Ledgehill, enrol yourself in one of our programs, or refer someone else, please call us at 800-676-3393.

An Important Update About the Omicron Variant

We are open and accepting patients. 

Since the beginning of the COVID-19 pandemic, we have been dedicated to keeping our patients safe as they recover from addiction or mental health disorders.

As the situation continues to evolve, as do our protocols and practices at each EHN Canada facility. And recent news of the highly-infectious Omicron Variant is no different. Please know that we continue to implement the highest standards of infection prevention in accordance with our local health authority.

If you have any questions about your or a loved one’s care and the protocols we have in place for staff, patients, and visitors, please contact us at 416-644-6345 or email at [email protected] 

Thank you and stay safe,
The Healthcare Team at EHN Canada