There are no plans to establish an NWT-based addictions treatment facility due to its high costs, said Health and Social Services Minister Julie Green on Thursday in the Legislative Assembly.
Green cited the example of the shuttered Nats'ejee Keh Treatment Centre in Hay River, which she said cost more to run than it would to contract out treatment services to six centres in the south.
Nats'ejee Keh closed down in 2013.
The health minister said that centre failed due to "a lack of a lack of suitable staff, the inability to do intake at any time and issues around confidentiality and people actually wanting to leave the North and all of their triggers for substance abuse and and have a new start in the south."
Her comments came in response to questions from Jackson Lafferty, MLA for Monfwi and Steve Norn, MLA for Tu Nedhé-Wiilideh about possibilities for opening such a facility in the territory.
"I feel like this is a missed opportunity," Norn said. "I really feel that we need to get more value for all of our programs and where we're spending our money. It pains me to see our funds go to the south."
Lafferty said a quarter of a million dollars was spent last year sending NWT residents south for addictions treatment, representing "a leakage of revenue that could have been spent on Northern jobs and business opportunities. But more tragically, it's a disservice to Northerners who stand a better chance of recovering when their addiction treatment is provided here in the NWT."
He added that the Truth and Reconciliation Commission's recommendation 21 calls for prioritizing the funding of healing centres in the NWT and Nunavut, and that former health minister Diane Archie pledged in June to provide more residential treatment in the territory.
"When can Northerners expect an end to the ill-advised practice of sending Northerners to southern institutions for addictions recovery?" he asked.
Green responded that she's unaware of that pledge from HSS and said that in fact two new facilities were recently approved for southern-based treatment, for a total of six, to allow for proper physical distancing during the pandemic.
"In the South ... people can get in right away, they can choose the place they want to go, they can be in a co-ed or gender-specific facility. And they have access to a range of services, which we simply don't have in the NWT.
"As a department we're focusing on things like after care, on-the-land healing and what supports we can put in place to help people hang on to their sobriety when they come back."
She said HSS' budget this year for addictions treatment is $2.3 million. There is $1.8 million available in a separate budget for on-the-land healing programs and each Indigenous Government Organization (IGO) can receive $125,000. Only about one-third of that budget has been spent, Green said, and she encouraged anyone who has connections with the program to apply.
But Lafferty questioned the quality of the NWT's after-care programs and said he knows of an individual who returned to the NWT after attending a southern treatment program and ended up "back on the street."
"Unfortunately, the individual passed away this past summer, because there was no after care program. This is a real life issue."
Green said HSS plans to begin surveying people who go to Southern treatment facilities by checking up with them to see if they completed their program or if they left early, and whether they were able to retain sobriety after they returned.
Money not the only cost
There is more to the issue of costs for an NWT-based treatment facility than just money, said Denise McKee, executive director of the NWT Disabilities Council.
"What is factored into the cost? Repetitive accesses, incarceration, strain on the health system and emergency services?" she asked.
"We know that the cost has to be measured by the social impact," she explained. "We see people returning from Southern placements, with little or no follow-up services and falling right back into their addictions. We saw people go from drinking multiple bottles of alcohol a day to a few ounces or complete sobriety, within 30 days, and then once this period ended transition to a single unit and immediately become immersed in their previous addictive behaviour, almost immediately."
There is no single approach that will work for everyone, and some people will prefer to go South for treatment whereas others will want to stay with their community, McKee said.
She criticized the approach to treatment that forces people to go South as "tantamount to medical colonialism" because the majority of individuals in the programs are Indigenous who must leave their communities.
"Dislocation from their families, is touted as, 'caring for' Indigenous peoples," she said.
The Disabilities Council advocates a range of short, medium and long-term solutions to addictions treatment, with the introduction of a treatment centre in the NWT among the long-term options.