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Profile - Substance Abuse Treatment and Rehabilitation in Canada

Gaps in services

The key informant survey did not reveal any common patterns of gaps or conditions that affect the delivery of effective services across the country. Multi-problem clients, injection drug users, problem gamblers and clients in rural communities were variously mentioned. Four jurisdictions identified services for youth as an area of need. The need for more culturally sensitive services for Native people and more gender-sensitive services for women was also noted. A broad survey conducted by the Quebec government in 1996 revealed that a strong continuum of service and effective "first contact" interventions from the general health and social services were regarded as the most important gaps.

The need to improve services for severely addicted clients within the justice system, an Aboriginal-specific intervention for men, and the need for community-based interventions for justice system clients were noted by CSC.

When asked to comment on services for specific populations, a variety of particular measures were reported. For adolescents, most respondents noted that special services existed or were being developed. These included residential and outpatient services as well as school-based services for those considered at risk. This contention appears to be supported by the program survey which indicates that 207 treatment programs (24%) in the country offer special services for youth. Forty-nine programs offer special services for inhalant abusers, most of whom are young people. Of note is the establishment of a provincial youth treatment strategy by the New Brunswick government based on a stages-of-change approach, and involving the recruitment of specialized youth counsellors in all regions and the provision of training for all guidance counsellors in the province.

Gender-specific or gender-sensitive programs were noted as being promoted, developed or available in all regions, except Prince Edward Island, where this was identified as a continuing need. Two hundred and twenty programs (25%) report offering special services for women. Saskatchewan is experiencing a high demand for services for Aboriginal women in abusive "co-dependent" relationships, whereas in Yukon a priority is the development of a comprehensive training program to prevent fetal alcohol syndrome (FAS) and fetal alcohol effects (FAE). Seventy-eight programs across the country make special provisions for pregnant clients.

Table 3: Prevalence of special substance abuse treatment programming in Newfoundlands

Newfoundland
Females	2
Adolescents	3
Pregnant clients	1
HIV+ clients	0
Dual disorders	0
Heroin users	0
Inhaler users	0

 

Prevalence of special substance abuse treatment programming in Nova Scotia

Nova Scotia
Females	9
Adolescents	11
Pregnant clients	0
HIV+ clients	1
Dual disorders	1
Heroin users	2
Inhaler users	0

 

Prevalence of special substance abuse treatment programming in Prince Edward Island

Prince Edward Island
Females	2
Adolescents	2
Pregnant clients	0
HIV+ clients	0
Dual disorders	0
Heroin users	0
Inhaler users	0

 

Prevalence of special substance abuse treatment programming in New Brunswick

New Brunswick
Females	6
Adolescents	5
Pregnant clients	1
HIV+ clients	0
Dual disorders	0
Heroin users	0
Inhaler users	0

 

Prevalence of special substance abuse treatment programming in Quebec

Quebec
Females	48
Adolescents	48
Pregnant clients	21
HIV+ clients	24
Dual disorders	34
Heroin users	22
Inhaler users	21

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Prevalence of special substance abuse treatment programming in Ontario

Ontario
Females	59
Adolescents	52
Pregnant clients	17
HIV+ clients	15
Dual disorders	37
Heroin users	11
Inhaler users	5

 

Prevalence of special substance abuse treatment programming in Manitoba

Manitoba
Females	9
Adolescents	5
Pregnant clients	3
HIV+ clients	1
Dual disorders	0
Heroin users	1
Inhaler users	2

 

Prevalence of special substance abuse treatment programming in Saskatchewan

Saskatchewan
Females	5
Adolescents	11
Pregnant clients	4
HIV+ clients	3
Dual disorders	3
Heroin users	1
Inhaler users	7

 

Prevalence of special substance abuse treatment programming in Alberta

Alberta
Females	10
Adolescents	15
Pregnant clients	7
HIV+ clients	5
Dual disorders	6
Heroin users	5
Inhaler users	6

 

Prevalence of special substance abuse treatment programming in British Columbia

British Columbia
Females	65
Adolescents	48
Pregnant clients	22
HIV+ clients	22
Dual disorders	18
Heroin users	14
Inhaler users	5

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Prevalence of special substance abuse treatment programming in the Northwest Territories

Northwest Territories
Females	4
Adolescents	6
Pregnant clients	2
HIV+ clients	1
Dual disorders	1
Heroin users	1
Inhaler users	3

 

Prevalence of special substance abuse treatment programming in the Yukon

Yukon
Females	1
Adolescents	1
Pregnant clients	0
HIV+ clients	0
Dual disorders	0
Heroin users	0
Inhaler users	0

 

Prevalence of special substance abuse treatment programming in total in Canada

Total
Females	220
Adolescents	207
Pregnant clients	78
HIV+ clients	72
Dual disorders	100
Heroin users	57
Inhaler users	49

In most regions, there are ongoing discussions concerning the treatment of substance abusers with mental health problems. In the meantime, special provisions for dually diagnosed cases do exist, with 58% of programs accepting clients with mental health problems and 100 programs offering special services.

Fifty-seven programs across the country offer special services for heroin addicts. Respondents from Newfoundland, Prince Edward Island and New Brunswick indicate a limited need for treatment for opiate addicts; the Northwest Territories and Yukon report that opiate addiction is on the increase and that new programs are needed. Elsewhere, there is a move to expand methadone maintenance treatment services and to license and train physicians for work with opiate addicts who have been stabilized on methadone.

The special need for business and industry to have easy access to assessment and treatment services is a growing issue, as corporate interest in substance abuse increases. In response, AADAC has established a treatment clinic specifically designed for business and industry. In British Columbia, a formal procedure smoothing access of EAP referrals to treatment has been established between government treatment services and employee assistance program associations in the province.