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Treat addicts with booze, says top doc
Dr. Jeff Turnbull suggests alcohol weening program could work in North

Terrence McEachern
Northern News Services
Published Friday, February 11, 2011

SOMBA K'E/YELLOWKNIFE - The president of the Canadian Medical Association is suggesting a program underway in Ottawa that gives doses of alcohol to homeless alcoholics on a periodic basis would be effective in helping Yellowknife address its problem with intoxication.

NNSL photo/graphic

Dr. Jeff Turnbull, president of the Canadian Medical Association, was in Yellowknife on Feb. 4 to attend the NWT Medical Association's general meeting. - Terrence McEachern/NNSL photo

"Yes, they're still drinking - a fraction of what they used to be drinking. But they have regained a great deal of respect and regained a bit of their lives where they're reconnected to the community around them and with their family," said Dr. Jeff Turnbull, who was in Yellowknife Feb. 4 to attend the NWT Medical Association's annual general meeting.

Turnbull said the Ottawa program offers clinical services in the city's homeless shelters with counselling for "veteran" alcoholics who have tried and failed abstinence-based treatments.

Turnbull said the program has 200 patients a day, which is 200 fewer homeless persons accessing the city's emergency room facilities.

"It's alcohol, as opposed to paint thinner or Purell (a hand sanitizer); so I know what it is," he said.

After six to eight months, Turnbull said the patient's condition starts to stabilize, and then counselling can help get at the root of the patient's alcoholism.

"We are always trying to reduce the amount of alcohol and actually get them to stop drinking alcohol. But it's not the principal goal. The principal goal is to return some degree of quality of life that they have," he said.

Turnbull added he knows the program is working when he sees patients, over time, wanting to reconnect with their families and becoming reintegrated into society. Turnbull said this type of program is definitely something that should be attempted in the North.

"You might not choose to do it exactly the same, but the elements are fundamental and I think they'd work no matter where you are," he said.

Lydia Bardak, executive director of the John Howard Society of the NWT, agrees that, in one respect, the program is beneficial in terms of providing the homeless with smaller doses of "only alcohol." She said this could reduce binge drinking and the consumption of alcohol-laced substances such as mouthwash, hand sanitizer and hairspray, which are prevalent because these items are easier to shoplift than alcohol.

However, the solution, said Bardak, is to help people heal and deal with the underlying issues of the addiction. But she's skeptical the program would be supported in the NWT, especially given that some communities in the North still ban alcohol. "But I think it's important to get the dialogue going about what kinds of programs would be effective and how can we better help people reach independent living and healthy lifestyles," she said.

Dr. Ewan Affleck, medical director of the Yellowknife Health and Social Services Authority, said he isn't familiar with the Ottawa-based program, but he said the premise isn't "revolutionary" because the health authority already gives patients reducing doses of a class of medication in pill form called benzodiazepines. This medication works on the same "receptors in the brain" as alcohol, he said. "They just don't go cold turkey, that would be sort of cruel," he said.

The alcohol-based program is something that could be looked at, but he added that the best treatment for alcoholism in the long term is Alcoholics Anonymous and similar programs.

The Ottawa-based alcohol management program started in 2003 with funding from the federal government. Since 2005, it receives about $600,000 a year from the Ontario provincial government, said Wendy Muckle, executive director of Ottawa Inner City Health, the organization that administers the program. The funding covers both the early stages of providing doses of alcohol to patients in order to stabilize their condition as well as the later stages of helping the patient reintegrate back into society through independent living, she said.

Besides alcoholism, another health care issue Turnbull sees affecting the North is doctor recruitment and retention. Turnbull said he's pleased to see physicians providing high quality and excellent care to patients. However, in terms of recruitment and retention, he said the key is training Northerners, who are more likely to remain in the North.

"That mantra - in the North, by the North, for the North, makes sense," he said.

A greater challenge is delivering health care in Northern communities outside of Yellowknife. He suggests that advances in technology such as telemedicine are key to supporting doctors in smaller communities provide effective health care.

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