How a Small First Nation Treats Addictions Close to Home


A small First Nation in Cape Breton took the initiative to address drug addiction by keeping its residents close to their homes.

In Wagmatcook, if you are struggling with an addiction, you don’t have to leave the community. In fact, for some, it is enough to go to one building, the Wagmatcook Health Center.

The centre’s holistic approach means patients can see a doctor, community health nurse, social worker, and dietitian, all in one place.

“I call it a one-stop-shop. You can come in and see one person and you can be transferred to the next person the same day, ”said Elaine Allison, director of the health center.

“We’re all in the circle of care together, so we’re able to work together and do our best to get this client to help them through this time.”

This is in stark contrast to the number of residents who received assistance in the past. Residents often had to travel over an hour to Sydney or North Sydney to access addiction services.

No travel

The center focuses on primary health care to treat people with drug addiction. This means that patients can see a family doctor they know and receive treatment for drug addiction as well as any other illnesses they may have, such as asthma or arthritis.

If a patient is struggling with other aspects of their life, they may see a social worker who can help with areas like family issues.

Providing services in one place helps break down barriers, according to Dr. David Martell, the centre’s physician.

In other communities, if a doctor feels a patient needs help from a specialist or a certain program, they may have to travel a long distance to get that help.

“And it collapses pretty quickly when you don’t have a license or you don’t have the money for gas, there’s no transit,” Martell said. “It’s the fragmentation of care. I think that takes away how effective it is.”

Dr David Martell is the centre’s physician. (Brittany Wentzell / CBC)

The Nova Scotia Health Authority offers an adult addiction day program in the Eastern and Central Health Zones. Wagmatcook people who want to access this program have to travel over an hour to Sydney.

Patients can also access mental health services through the Mental Health Line, but wait times can be long depending on the urgency of the patient’s case and where they live.

Martell’s presence in the community means residents no longer need to travel to North Sydney to see a psychiatrist in order to be prescribed long-acting synthetic opioids like methadone. Martell can prescribe and patients can pick them up at nearby Baddeck.

Treat people the same

Another barrier that people with substance abuse face is not having a primary care provider or one that the patient knows and trusts.

Martell is a physician in Lunenburg. He spends several days a month in Wagmatcook and makes virtual appointments upon his return to Lunenburg.

As a family doctor, he slowly began to specialize in the treatment of drug addicts. Martell remembers a time when, when treating a young man in Lunenburg, he recommended that he seek help in a larger, more urban center.

“Upon reflection I thought that was a very shameful thing to say and that it was a very bad reflection on our system. So I took the emotion and the energy of that and I took it. invested in learning how to do it myself. “

He said treating people with drug addiction doesn’t have to be complex, but some primary care providers often don’t feel equipped to do it and then send people further afield for help. Martell believes doctors should leave the stigma and preconceptions at the door and treat addictions like any chronic illness.

“Even if we did nothing more than just treat people with addiction disorders the way we treat everyone else, we would go a long way in solving the problems they have,” he said.

“I think my mission is that someday people will think of nothing more about helping someone who has an addiction problem than helping someone who has diabetes.”

Solve problems around tea

Allison said the Wagmatcook model is not just about having easy access to services, but also having the support of the Mi’kmaw community.

“We have a Chief and Council who are very, very supportive of this program… and at any time clients can speak to the Chief and Council or Council of Elders. “

The idea for this support model, she said, came from a program provided by the health center for several weeks in 2017.

Back then, patients with substance abuse disorders often had to travel to Sydney or North Sydney for treatment.

“They spent all day traveling which was not good. They couldn’t go on with their lives, they couldn’t go, they couldn’t keep a job because they were going to Sydney.”

When these patients returned, former chef Mary Louise Bernard spent time with them in groups, cooking, drinking coffee and tea, going into the woods, discussing her dreams, and holding sacred ceremonies like cleansing.

“My mother and my godmother, they solved everything over a cup of tea and that was kind of my motto at the time,” said Bernard.

Former Wagmatcook chef Mary Louise Bernard. (Submitted by Mary Louise Bernard)

Bernard said the health authority’s day program was helpful, but participants sometimes found it rigid. Bernard would meet the participants afterwards and let them tell him what they needed and wanted to talk about. Sometimes that involved cleaning their house or even doing chores together, like going to the dentist.

Measuring success

Allison said the health center’s methods have helped reduce opioid addiction crime in the community.

“At its peak there was a lot of crime, people were scared they weren’t going to open their doors because people were looking for stuff and trying to steal,” she said. “Police say there is little crime in the community now.”

But proof of the centre’s success can be seen in the patients themselves, Allison said.

“A lot of them now have jobs, they’ve got their kids back. It’s a really wonderful program. It is really wonderful what they were able to accomplish. “

Allison drafted the proposals for funding for the health center services. She hopes to one day offer even more to the community, including a detox space for residents. Currently there are eight detox beds in Cape Breton. They are all in Sydney.


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