Anglo patients being turned away

South Shore rehab centre lacks enough doctors for emergencies

The only English-language substance use rehabilitation centre on Montreal’s South Shore is turning away the most severely addicted patients because there’s no doctor available on call to treat them in case of emergency.

The in-patient program of the Foster Addiction Rehabilitation Centre (CRD Foster) in the Montérégie, a public rehabilitation centre in the Quebec health and social services network, is currently functioning under capacity at 75 per cent — with six of 24 beds not filled — because heavy cases require medical intervention.

CRD Foster has told its partners it’s no longer accepting such cases, Francis Collins of the health-care union Alliance du personnel professionnel et technique de la santé et des services sociaux (APTS) said Tuesday.

“Our fear is that people will be left all alone with their problem if a doctor is not found,” he said.

These patients are being told to go to a hospital emergency room, Collins said.

“That runs directly counter to efforts to reduce overcrowding in emergency rooms.”

Collins estimated that 18 people will be denied services each month.

The situation has major consequences for the anglophone population and for the regional health and social services network, he said.

Problems began in 2017 when the Montérégie- Ouest health department couldn’t find a permanent physician for its centre. It hired three doctors, Collins said, one after the other.

They’re trying to get better and we’re putting barriers in their way.

Now its current physician who is slated to leave in August works at the centre Thursdays, for half a day. She was hired in January for a six-month contract ending in June, which has been extended until the end of the summer while the department seeks her replacement.

Clients needing in-patient addiction services are referred from the centre’s outpatient clinic and hospitals in the Montreal area.

The centre can handle those addicted to pot and gambling. But the most severe addicts, for example, those addicted to narcotics or alcohol, are now being turned away if their situation is evaluated as too risky.

“We are refusing (to admit) the most severe patients because the doctor is not on call,” explained Fady Zigby, an educator with the in-patient program for nearly seven years. “If anything happens, we can’t contact anyone.”

“With heroin, you just feel like you’re dying. But with severe alcohol addiction, you can have seizures, delirium tremens, hallucinations, shocks to the brain — you can die from alcohol withdrawal,” Zigby said.

Some people are less forthcoming about their addiction during an evaluation, he added. They admit to consuming six drinks a day when it’s actually 15, which means the detox will be riskier.

The program has 24-hour nursing staff to monitor patients. But clients in the program facing an emergency — for example, they need their medication tweaked — get sent to the ER “because we don’t have the proper medical staff to support them,” he said.

“It’s tough on them. It affects their motivation. They ’re trying to get better and we’re putting barriers in their way.”

COLD TURKEY

Health workers say a few try to detox on their own and then give up. Some go cold turkey without any prescription medication or followup, and others go to the ER and get drugs to ease withdrawal symptoms — such as the sweats, shakes and nausea — over several days.

The union says it approached the Montérégie- Ouest health department in March with its misgivings. The health department seems to lack the commitment to find CRD Foster a doctor, the union said. Meanwhile, the French-language Virage centre has two doctors on call and one on staff, workers said.

The department failed to find a physician in time for the June deadline, and there’s little hope on the horizon they’ll be able to do it by August, Collins said, and this is the only public addiction rehabilitation centre for the Englishspeaking population on the South Shore.

However, the health department disagreed. Officials say they are treating the matter with high priority to solve the problem as quickly as possible. Recruitment is difficult because of a shortage of family doctors in the region, officials said in a statement.

“Please be assured that we are taking all the steps necessary to ensure that all patients with complicated withdrawal symptoms who need in-patient detox treatment receive the proper services,” the department said.