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Opinion: More Alcohol Visits to ER than Heart Attacks – Time for an Intervention

Apr 13, 2018 | Business

By Alison Strachan

Two weeks ago, The Macdonald Notebook reprinted parts of an opinion piece I wrote for a national publication in 2016 (Rob Ford and Mad Men – Let’s Talk About Addiction and the Family, March 30th, 2018 edition).

That reprint resulted in social media and web traction as far away as British Columbia and as close as the Nova Scotia Legislature which, on Wednesday of this week, published Hansard comments from Tuesday on its website.

At page 3808 of Hansard, an exchange occurred between Elizabeth Smith-McCrossin and Health and Wellness Randy Minister Delorey.

Fisherman's Market: Seafood Delivered Overnight Throughout Canada

Ms Smith-McCrossin asked:

I would like to ask the Minister of Health and Wellness the question, will the minister commit to restoring the funding for the program called Affected Others, and also the Addiction Services in downtown Halifax?

The answer from the health minister was that the services that McCrossin-Smith referred to were “still being offered within the Halifax area…So, that work and those services are still being offered by the Nova Scotia Health Authority.”

Would the minister like to expand on that for me and tell me where, in fact, the Affected Others meetings are being held that are provided by the Nova Scotia Health Authority? I can’t find them.

And while he went on to talk about the wide variety of programs and services being “provided for people with mental health and addictions services” (sic), and identified the worthy Bloom Program, he seems unaware of recent significant and critical reports about alcoholism in Canada and its impact on health care resources.

But before going to those recently released statistics, the Bloom Program targets people living with an addiction and/or mental illness that is causing functional impairment who are prescribed one or more psychotropic medications.

In other words, alcoholics not prescribed psychotropic medications need not apply to the Bloom Program.

In a report released in 2017 by the Canadian Institute of Health Information: Alcohol Harm in Canada: Examining Hospitalizations Entirely Caused by Alcohol and Strategies to Reduce Alcohol Harm, the authors reach this conclusion:

“…there are more hospitalizations for alcohol than for heart attacks. In 2015-16, there were about 77,000 hospitalizations entirely caused by alcohol compared with about 75,000 for heart attacks.”

I recognize that is a Canada-wide statistic. In that study, however, more than 20 per cent of Nova Scotians reported heavy drinking from the age of 12.

Yes, you read that correctly — 12.

Nova Scotia also got the bronze medal in Canada for its drinking numbers.

Alcohol dependence creates challenges for an already challenged health care system but responses saying programs exist — that clearly do not — is not acceptable and casts doubt on the overall veracity of the minister’s response to any questions on Addiction Services.

Leaving opiates aside, the recent statistics on alcoholism are overwhelmingly in favour of investing in the family as well as in available and accessible treatment (by that I mean individualized behavioural and dialectic counselling) and services for those who are harmfully involved with alcohol.

In other words, we need our government to be proactive and not reactive as our health care system struggles to meet demands from alcoholism (remember more hospital visits than for heart attacks) that could have been met earlier through responsible healthcare intervention and community treatment.

Recently, I was in a hospital in Nanaimo, B.C., because someone I know and care about from Nova Scotia relapsed while travelling alone.

On entering the downtown hospital emergency rooms, I noticed that mental health and addiction services were located just off the suite of emergency rooms.

Not in a strip mall a few kilometres away as it now is in Halifax.

I listened as the doctors and other health care providers compassionately spoke to my friend by referring to her situation as “terminal” and their firm recommendation that she make a decision to go to detox and treatment.

They were treating her, as they should treat her, as having a treatable illness, as they would be if treating cancer, diabetes, heart conditions, etc.

I listened in utter amazement as they themselves telephoned a detox that is part of the health care community and then informed us that there was a bed available almost immediately.

All the while that I was listening, they were administering fluids, vitamins, and minerals in an attempt to stabilize this individual and to avoid the potentially fatal seizures alcoholics are exposed to in withdrawal.

Withdrawal from alcohol is reportedly more dangerous than any other substance withdrawal process. As I understand, it’s not something you can ‘just give up’ on your own with willpower, although that “splitting hairs” debate rages on by the uninformed.

I have been to emergency rooms in Nova Scotia with two other people who suffered health consequences from alcoholism. In both cases, there was no form of intervention like what I witnessed in Nanaimo.

In the cases I saw here, the individuals were sent home after some monitoring, with a handful of drugs to “help” them with withdrawal at home.

Neither individual was provided with information on how to navigate their way through and to Addiction Services.

In Nova Scotia my experience was that this is mainly left to the family or ‘Affected Other’ to figure out.

One of those individuals ended up suffering a traumatic brain injury from a fall while intoxicated. He ended up in the Nova Scotia Rehabilitation and Arthritis Centre for almost a year and now lives in a continuing care facility.

You do the math.

The other, my husband, eventually died from a tragic fall. Many alcoholics die from a fall, Richard Burton for example.

During the last of my husband’s five or more emergency hospitalizations, he was actually told by a physician that he just needed to decide to quit drinking and go to Alcoholics Anonymous. Without diminishing AA in any way, this was perhaps the worst advice to give to a terminal alcoholic.

I continue to feel to this day that an appropriate intervention by that physician would have seen him seek MSI-approved treatment at Homewood in Ontario or Montreal.

Incidentally, one of the key staffers at Homewood in Montreal is Dr. Ronald Fraser, who also has a close relationship with the Nova Scotia Health Authority. Currently, its webpage says he acts in a consulting role with the authority. I wonder if those who ordered the changes to Addiction Services consulted with Dr. Fraser who, in 2015, won a prestigious national award for Clinical Leadership and Innovation for his work in establishing evidence-based addictions programming.

If the health care system is not supporting evidence-based addictions programming in a holistic manner (i.e., integrating Addiction Services into a treatment plan right from the hospital patient presentation), our hospital practitioners are unable to effectively “intervene and treat the patient for alcoholism.

As for the late great Affected Others program?

It is indeed dead and has been since the summer of 2016.

I urge the Honourable member to fact check more closely. It goes a long way in terms of overall credibility.

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