NWT plans to expand detox, withdrawal management

The NWT’s health minister says her department plans to improve the coordination and delivery of addictions care.

Lesa Semmler said that will mean creating a territorial addictions medicine team and hiring clinical staff specialized in addictions.

The Department of Health and Social Services will spend the next three years establishing inpatient medical detox programming, community-based withdrawal management, and outpatient withdrawal management.

Semmler first announced the plans in a statement to the legislature last month, while outlining how the territory expects to spend $36 million over five years in new healthcare funding from the federal government.

The NWT’s health authority has since expanded on the detail.

Yellowknife North MLA Shauna Morgan said current detox programming in the NWT is a “patchwork,” only offered at Stanton Territorial Hospital to people with significant medical risks. She said that accounts for “very few of the patients who would actually benefit” from withdrawal management.

Withdrawal management is a term for care offered to people who are in the act of ceasing or reducing their use of a drug or other dependence.

“I’m encouraged that this is on the radar and we’re heading in this direction,” Morgan told Semmler in response to the minister’s announcement.

Asked by Morgan whether staff would adopt best practices from withdrawal management programs elsewhere, Semmler said the programs rolled out will be tailored to suit the NWT.

“We need a program that’s going to fit the needs of the Northwest Territories and be able to support small communities, regional centres and Yellowknife, and the residents that need the service,” Semmler said.

What will change?

The NWT’s health authority said inpatient medical detox services are currently provided at hospitals and health centres in Yellowknife, Fort Smith, Hay River and Inuvik on an ad-hoc basis, when a bed is available.

Detox services are also offered to NWT residents through agreements with inpatient facilities in the south.

The final report on the NWT government’s progress on its mandate from 2019 to 2023 said expansion of medical detox and withdrawal management had been delayed by a need for more money and staff.

The health authority said the new federal funding will allow for two dedicated beds at Yellowknife’s hospital. Access to inpatient medical detox will still be offered on an ad-hoc basis in other locations.

“Funding will also support program development that will contribute to clearer referral pathways and enhanced support and education for staff,” the authority stated.

“These changes will support service delivery across the NWT by providing resources that support care in acute care sites, and by enabling providers with better tools, processes, and system coordination for the delivery of community-based supports.”

According to the health authority, $879,000 in funding will go to the addictions program in 2023-24, $2.8 million in 2024-25, and $3.6 million in 2025-26.

The authority said the first year of the program will focus on implementing inpatient medical detox, preparing the health system for a coordinated approach to outpatient withdrawal management, and ensuring existing substance use programs have enough resources.

The second and third years, the authority said, will see a phased expansion of outpatient withdrawal management, case management, nursing support for substance use medicine services, and telehealth and virtual care services.

A report from the Canadian Centre on Substance Use and Addiction found substance use cost the NWT more than $230 million in 2020 – the latest data available – including the cost of lost productivity, criminal justice and healthcare.

Of that figure, $40 million was attributed to healthcare costs, $24 million of which were related to alcohol.

In 2020 there were 3,667 emergency room visits, 525 inpatient hospitalizations and 73 deaths associated with alcohol use in the territory, according to data compiled by the Canadian Centre on Substance Use and Addiction.

The NWT government launched a long-awaited alcohol strategy in March 2023, aimed at reducing alcohol-related harms.

One of the strategy’s goals is to build regional programming and harm reduction capacity, including supports for withdrawal management in smaller communities.

Semmler said the new federal health funding will pay for some other initiatives, like establishing a territorial public health unit.

A position will also be created to help Indigenous governments and organizations access funds dedicated to suicide prevention, and community wellness and addictions recovery.