Sunday, 13 January 2013

Therapeutic Courts

I am very encouraged by the province’s interest in therapeutic courts, which offer a more humane approach to addressing drug addiction – a chronic, often relapsing brain disease that causes compulsive drug seeking and use – than the traditional punitive model that focuses on punishment.  With approximately 80% of the cases before PEI courts today being drug-related, something different needs to be done. I applaud Justice Minister Janice Sherry for trying to find a new approach. 

Some of the most positive aspects of therapeutic courts that I can see include:

1.      The fact that we will no longer jail people who are sick (or at least we’ll be giving them an option to go to treatment). Crime is a symptom of drug dependence whereby the individual is doing whatever is necessary to feed their addiction. Jail will not make them better but treatment might.

2.      If done right, they will save money in the long run as they will help to stop the “revolving door” that we see now where addicts are sent to jail and end up back before the court within months of being released. They go in as addicts and come out as addicts.

3.      They will help addicted Islanders find recovery. While relapse is common with this disease, the treatment they receive will never lose value. Treatment tends to be a positive experience that addicts can call upon in their darkest days, and can serve as motivation to get clean and stay clean. In other words, they learn that there is a better way of life when they are ready to embrace it.

4.      Individuals will be given an opportunity to overcome their addictions and make meaningful contributions to society without being saddled with a criminal record. I am making an assumption here that part of the offer will be no criminal record for minor drug-related offences.

5.      Families will become healthier if loved ones are given treatment for their addiction. In the case of families where a parent(s) is addicted, they will be able to get the help they need to overcome their addiction while acquiring the life skills necessary to create a positive and nurturing environment for their children to grow up in. This will also lighten the load being carried by our foster care system.

To ensure that we achieve the best possible outcome in the court cases, we will have to invest in our Addiction Services, which are having a hard time to keep up with the number of people voluntarily seeking help. If we add more to their caseloads without an investment in programs, the system will not be able to handle it.

Based on our family’s experience, I have listed some of the challenges that clients face when seeking treatment for addiction, and some possible solutions.

Challenge: The wait can be up to 3 weeks to get into detox at Mt. Herbert, and the stay is not long enough.  When you call the detox unit at Mt. Herbert you are put on a waiting list. Your wait can be up to three weeks. Most experts agree that when an addict says they want help, it has to be available right away because the next day may be too late. They also recommend that detox stays be a minimum of 14 days. Solution: Make more beds available at the detox. Build an addition to the facility, if needed. Also, make the stay longer than 7 days for those not entering a rehab program straight from detox.

Challenge: The wait times are too long for rehab after detox (a time when addicts are new to recovery and most at risk of relapsing).  The Island offers a few short-term rehab programs including the 8-week Strength day program for youth, and an alternating one-month rehab program for men and women. In each program, you have to wait for the new session to start before you can get in. The wait can be up to two-months if the program is just getting started. Many addicts relapse during this wait time. Solution: Have weekly intakes for the Strength program. For the one-month rehab programs, have a women’s and a men’s program every month. That way, you can have daily (or at the very least, weekly) intakes.

Challenge:  PEI is the only province that doesn’t have its own long-term residential treatment centre. Treatment options need to include either a long-term residential treatment centre of our own or an open door to other treatment centres off-Island. Islanders battling addiction face major obstacles to get into residential treatment, with many being refused the opportunity to get this help. This is most unfortunate because it offers their best chance at recovery. According to a recent Johns Hopkins study, a six-month residential treatment program has a 50% success rate, which is higher than any of the other options offered. Solution: Expand the building at Mt. Herbert to accommodate a residential treatment centre or find another location for it. We could also talk to established facilities like Portage Atlantic about opening a location here.  

Challenge: The physical location of Mt. Herbert Addiction Treatment Centre is a barrier to those seeking help. We need to make our Addiction Services programs more accessible. Currently, most of the services are housed in Mt. Herbert, which is on the outskirts of Stratford. This provides a major obstacle because of transportation costs. Public transit does not go that far out, and cab fare can be upwards of $30 per trip from Charlottetown. The barrier is even greater when you live in rural Prince Edward Island. Most people battling addiction simply do not have the money for gas nor do they have vehicles.  In addition, most do not have anyone they can ask for a drive since relationships tend to get ruined during periods of active addiction. Solution: We need to move the services (counseling, Methadone maintenance, and other support) into our cities and towns where they can be accessed by the majority of people.

Challenge: The waiting list is too long for the Methadone maintenance harm-reduction program. It is my understanding that qualified candidates for Methadone maintenance face a waiting list with well over 100 people on it. This translates to a wait time of approximately 3 years. Solution: Train more doctors in Methadone maintenance to meet the demands.

Challenge: Many family members are not educated on addiction, which can hinder the recovery process for their addicted loved ones. Treatment programs should include family engagement. Healthy families can be a key factor in successful recovery. Addiction is well acknowledged as a disease that affects the whole family. Many families are living the nightmare of addiction without even understanding what the disease is or what they can do to help their loved ones get better. For this reason, they may become enablers to the disease (meaning they do more harm than good). Help to make the families healthy so that their loved ones have a better chance of staying in recovery.  Solution: Expand the family program at Mt. Herbert by offering it more often and take it on the road to various communities on a regular basis.

Finally, I would like to make a few points specific to therapeutic courts:

1.      One should not have to commit a crime before they can access adequate treatment. Individuals battling addiction need to have timely and adequate treatment options BEFORE a crime ever takes place.

2.      The treatment assigned in therapeutic courts should not only include abstinence-based options. They should include a combination of harm-reduction and treatment for those addictions that are more chronic and serious in nature. Demanding complete abstinence will lead to failure in many cases.

3.      In court, the accused should have to hear family impact statements so that they realize the extent in which their addiction is affecting others. These impact statements should be from their own family members and friends, much like we would see in a staged intervention. It will set the stage for treatment and healing for both the accused and their families.

4.      Those individuals seeking treatment through therapeutic courts should not trump those who are seeking it voluntarily. We have to ensure that there is adequate support for both groups of people.

I feel very strongly that Prince Edward Island can be a leader in this country in getting this epidemic under control with the right financial investment in treatment (and prevention) programs and through therapeutic courts. I’ve heard from many addicts who felt that they were forced into treatment but are now so grateful for it. They claim that when they were away from drugs and the fog cleared from their minds, they could see that life was better and they were motivated to keep it that way.   

It is my opinion that in order for a therapeutic court to be successful, Minister Sherry will have to work in close partnership with her colleague Health Minister Doug Currie. I look forward to seeing their leadership in action on this issue.



  1. I would like to see a Detox/Rehab Centre returned to Summerside. There are lots of empty buildings around that could be adapted for use. The abandoned spa by the water front would be an ideal location. The old Regent could have some renovations done to it and be made ready. There are empty businesses and warehouses that only require additional plumbing, wiring and partitions. If Habitat for Humanity can build homes, why can't they help build/renovate something this necessary? Just a thought.

  2. Excellent article, Rose. You've raised so many good points. I would like to see better youth facilities on PEI. Having only 2 beds at Mt. Herbert devoted to youth under 18 doesn't begin to meet the need.

  3. Great article, Rose. You've raised so many good points. I would like to see much improved youth facilities on PEI. Having only 2 beds devoted to inpatient detox at Mt. Herbert for youth doesn't come close to meeting the need.


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