The Nova Scotia Health Authority has changed the way it delivers detox programs to move away from hospital stays and toward more day programming and community-based support, but not everyone is on board with the idea.

Gone are the days when patients could call their local detox to "book a bed," said Sam Hodder, senior director of mental health and addictions for the health authority.

She said people seeking help with alcohol and other addictions are now formally assessed and matched with the appropriate level of treatment, which may not include hospital admission.

Maintaining recovery

Hodder said some hospitals in the province no longer staff their detox units around the clock and bring in staff overnight only when necessary.

"Some people, based on the severity and the complexity of their needs, do require hospitalization," she said. "It's based on need and demand, and what's the right fit for the patient."

Hodder said day programs have been expanded in an attempt to offer a wider "continuum" of care beyond in-patient care.

She said the changes are based in part on an examination of best practices across the country.

Hodder said a review of detox options in Nova Scotia identified the need to better define the criteria for admitting a patient to hospital, and for offering care beyond a hospital stay.

Figures released by the Canadian Institute of Health Information in 2017 suggested that Nova Scotia was 10 times more likely to admit someone for detox than the Canadian average, said Hodder.

Sam Hodder is the senior director of mental health and addictions for the Nova Scotia Health Authority. (Wendy Martin/CBC)

She said those numbers are steadily declining, in part because the health authority has moved away from in-patient detox for people with opioid-use disorders.

"It's actually really dangerous," said Hodder, adding that rapid detox from opioids carries an increased risk of relapse or overdose once the patient is released from hospital.

Mixed reactions to new approach

Hodder said expanded day programs for many types of addiction treatment can offer people more options for a successful recovery in the long term.

Reviews of the new approach are mixed.

A representative of Alcoholics Anonymous in the Port Hawkesbury area said he likes the expanded day programs.

The representative told CBC News there's "more onus" on the participants to show up and "get sober."

The executive director of Talbot House, a residential recovery house for men in Cape Breton, said people who would benefit from in-hospital detox are being turned away.

"It offered security, you know?" said Tom Blanchard. "Somebody who's being abused at home, not being able to stay in detox takes that element away."