Recovery is pretty binary for addicts—you’re either in recovery, or you’re not. However, there seem to be as many paths to recovery as there are people seeking it. Whether they get sober in treatment, incarceration, in church or in therapy, everyone’s story is different.
In Canada, however, the options for heroin addicts just got a little more limited. The Nova Scotia Health Authority is shifting away from publicly funded detox and moving toward a system where people with opioid addictions are sent directly to Medication-Assisted Treatment (MAT)—specifically, methadone therapy.
The reasoning: detox sets addicts up for life threatening overdoses, which has led Nova Scotia health authorities to opt for skipping treatment programs altogether. Dr. Linda Courey, Nova Scotia Health Authority’s director of mental health and addictions told CBC, “Not to say it’s not ever effective in some cases, but for most people that transition from living in a protected environment to their community is extremely difficult to navigate.” Detox and treatment centers that don’t produce the desired effect also aren’t budget-friendly. Why keep pouring money into a detox program that doesn’t keep addicts sober?
Why Eliminate Detox For Heroin Addicts?
According to Drug Rehab Services, there five detox programs in Nova Scotia—one of which is a medical detox. Just like in the States, these programs provide 7 to 10 days of inpatient care for individuals who need to detox before entering a treatment facility or a long-term rehab. Detox is a safe, professionally monitored environment and is often the first stop for addicts who hope to make it to long term recovery. According to the Recovery Village, a Florida rehab facility providing a continuum of recovery care, a relapse after detox can be fatal because detox resets the addict’s metabolic system but doesn’t change the mental cravings for a particular dose of drugs, or the emotional reasons behind the user’s addiction; that’s where more intensive treatment—like a residential program or Intensive Outpatient Program (IOP)—come in.
A Miracle Drug for Some, a Nightmare for Others
This means that if you’re an addict in Nova Scotia, you might have to get onto methadone in order to get off of heroin. From a numbers standpoint, it makes more sense. According to the California Society of Addiction Medicine, “Detoxifications and drug free modalities, although appealing to an understandable desire for recovery without medications, produces only 5-10% success rate. Methadone maintenance is associated with success rates ranging from 60 – 90%. The longer the people are in this modality the greater their chances are of achieving stable long-term abstinence.” Instead of waiting for addicts to succeed in treatment programs, Nova Scotia policy makers are pushing them towards methadone—which may not be a perfect solution, but has a statistically better outcome than drug-free detox.
Methadone is a prescription medication. It’s an opioid that is commonly used to help heroin addicts transition away from street drugs or other opioids by reducing the physical pain and cravings of active addiction and withdrawal. However, methadone can be abused, is habit forming and can be lethal in large doses or in combination with other drugs. For these reasons, many heroin addicts who are desperate to get clean don’t want to take it. A rep at Novus Detox, said, “Withdrawal from methadone is often even more difficult than withdrawal from heroin. Few methadone users have been successful in withdrawing from methadone on their own.”
Addicts and health authorities may share the same goal (getting sober for good, without reliance on an outside system), but they don’t necessarily agree on their methods. Given no alternative, addicts may refuse to switch from heroin to methadone, and with fewer detox centers, this could actually lead to more overdoses. Also, for some treatment programs, methadone users aren’t welcome. These issues complicate things for policy makers. With no “perfect solution” and a high-risk population, Nova Scotia is dealing with problems that plague lawmakers all over the world. Limited research on what works to treat addiction only complicates matters.
Treat Yo’ Self
Having options in recovery empowers addicts. Whether someone gets sober in a jail cell, a church basement, on an ayuhuasca trip or with a methadone prescription, that choice is powerful. Limiting recovery options for heroin addicts, as they are doing in Nova Scotia, risks alienating drug users who need help.
Even under the best of circumstances, treatment may not be a sure thing, but seeking help is a crucial first step for the many people who are navigating the difficult territory of early recovery. Although there’s one ideal outcome—long term, stable sobriety—there are many ways to get there. But by limiting access to options, the Nova Scotia government is only setting up more road blocks to recovery.