Substance Abuse in Quebec: Where to Find Help

Visit substance dependence is a medical condition, not a personal failure [1]. In Quebec, several Free and confidential resources are available to help you start making changes at any point along the journey. This article provides an overview of the signs of addiction, the main entry points, available treatments for alcohol and opioids, and strategies for harm reduction and resources for family members.

On this page

• Understanding Addiction: A Medical Condition
• Recognizing an Addiction
• First Point of Contact: Drugs: Assistance and Referrals
• Public Rehabilitation Network
• Opioid Treatments
• Alcohol and Other Substances
• Harm Reduction in Quebec
• Support for Family Members
• Youth and Addiction
• Myths and misconceptions
• Frequently asked questions
• Sources

Understanding Addiction: A Medical Condition

Visit dependency (or substance use disorder) is now recognized as a chronic medical condition, just like diabetes or high blood pressure [2]. It involves changes neurobiological of the brain, particularly the circuits of the rewardthe motivation and of control.

Why It's Important

• Reduce the stigmatization and guilt
• Justifies a medical treatment, not just a matter of willpower
• Allows to speak openly with a professional
• Increases the chances of recovery in the long term
• Recognizes the complexity of the condition (biology, psychology, environment)

To remember

• Visit dependency is a medical condition, not a personal failure
• Several Free and confidential resources are available in Quebec at any point along the journey
• First entry point: Drugs: Help and Resources to the 1 800 265-2626, available 24/7
• Visit public network (CIUSSS/CISSS, CRD) offers free services, without a doctor's referral in most cases
• From proven treatments are available for opioids (methadone, buprenorphine/naloxone), alcohol (naltrexone, acamprosate, disulfiram), and other substances
• Visit naloxone (Narcan) is available for free at pharmacies and saves lives in the event of an overdose
• Visit harm reduction is a complementary approach that saves lives even when resuscitation is not the immediate goal
• Visit Neighbors also have access to resources to stay informed and protect themselves

Recognizing an Addiction

Visit dependency is not limited to the amount consumed. The DSM-5 defines substance use disorder as eleven criteria, with at least 2 or 3 episodes over a 12-month period to be classified as mild, moderate, or severe [3].

The Main Signs

• Consumption which spirals out of control despite the desire to reduce it
• Tolerance (need for increasing amounts) or symptoms of weaning
• Significant time spent obtaining the substance or relying on it
• Impact on the work, the relationshipsthe health
• Continued use despite the known consequences
• Waiver or reduction of’activities important
• Use in various situations dangerous (driving, work)
• Intense Desires (craving) to consume

Substances Most Commonly Found in Quebec

• Alcohol : the most commonly used substance, with significant health costs
• Opioids : prescription drugs (oxycodone, hydromorphone, medical-grade fentanyl) or illicit drugs (heroin, street fentanyl)
• Cannabis : problematic use among some consumers
• Stimulants : cocaine, crack, methamphetamine
• Benzodiazepines : Risk of dependence with prolonged use
• Tobacco and Nicotine : the most common form of addiction
• Polydrug Use : common, complicates treatment

When to consult

• Concern personal attitude toward his or her consumption
• Request for a nearby to consult
• Consequences on work, school, and relationships
• Withdrawal symptoms at a standstill
• Attempts repeated to try unsuccessfully to reduce
• Comorbidity mental health (depression, anxiety, PTSD)
• Presence of signs of an overdose or medical complications
• It is not It's never too early, nor too late to seek medical advice

First Point of Contact: Drugs: Assistance and Referrals

The flagship service in Quebec

• Line free of charge and confidential
• Accessible 24 hours a day, 7 days a week
• Number: 1 800 265-2626
• Online Chat: aiderefer.com
• Available in French and in English
• Facilitators trained in helping relationship and outbuildings

What You'll Find There

• Listen and immediate support
• Information on substances and their effects
• Information about the programs processing
• Reference toward appropriate local resources
• Support is also available for Neighbors
• Support in the reflection and decision-making
• Help in situations of crisis

Why Call

• For to speak about their consumption, without judgment
• To understand the options available in his area
• To get information on a substance
• To be accompanied in decision-making
• To find your way as a nearby
• In a situation where’concern or a crisis
• To get a reference toward a specific program

Public Rehabilitation Network

Visit public network This Quebec institution offers a variety of programs, organized according to a step-by-step approach, from brief intervention to specialized care [4].

CIUSSS/CISSS Programs

• External Services : clinical follow-up, either individual or in a group setting
• Internal Services : residential program with intensive supervision
• Detoxification : medically supervised withdrawal
• Programs specializing in youth, women, poly-substance use, and co-occurring disorders
• Approach step-by-step: assessment → brief intervention → specialized treatment
• Free, without medical reference in most cases
• Tracking Long-term care and recovery support

Substance Abuse Rehabilitation Centers (CRD)

• Centers specialized in care facilities, integrated into the CIUSSSs
• Presence in each region of Quebec
• Teams multidisciplinary: doctors, psychologists, social workers, specialized professionals
• Programs appropriate to various substances and profiles
• Evaluation Initial assessment, intervention plan, follow-up
• Link with community and medical resources

How to Access It

• Call Drugs: Help and Resources for guidance
• Contact the CLSC in your area
• Direct request to the CRD in your area
• Referred by a doctor or an IPS
• Referred by a another speaker (school, workplace, social services)
• Waiting Periods variables depending on the region and the program
• Intervention fast in case of an emergency

Opioid Treatments

Visit opioid crisis has left its mark on Canada and Quebec over the past decade. Some proven treatments exist and save lives [5].

Opioid Agonist Therapy (OAT)

• Methadone : long-acting opioid agonist, prescribed in specialized clinics
• Buprenorphine/naloxone (Suboxone): partial agonist, prescribed more widely by doctors and trained addiction treatment professionals
• Decrease in cravings, weaning and street drug use
• Reduction significant mortality from overdose
• Available in outpatient clinic or by program at low threshold (easy access, no formal appointment required)
• Treatment often involves long term, sometimes for several years
• Covered by the RAMQ according to the criteria

Naloxone: Saving Lives in the Event of an Overdose

• Naloxone (Narcan) : an antidote that temporarily reverses the effects of an opioid overdose
• Free at pharmacies in Quebec for anyone at risk or their loved ones
• Available in nasal spray or by injection
• Training short-term use available at pharmacies or community organizations
• Save lives — always call the 911 in addition
• Also available through community organizations and harm reduction sites

Signs of an opioid overdose

• Respiration very slow, irregular, or stopped
• Cyanosis (blue lips, blue nails)
• Loss of consciousness, inability to wake the person
• Very dilated pupils contracted («the head of a pin»)
• Rales, abnormal snoring
• Action: 911, naloxone if available, recovery position
• Visit Good Samaritan Law (The Good Samaritan Law for Assisting Overdose Victims) protects people who call for help

Alcohol and Other Substances

The’alcohol dependence is the most common and one of the most treatable. Several approaches coexist and complement each other.

Medications for Alcohol Dependence

• Naltrexone : reduces the pleasure derived from alcohol, decreases relapses
• Acamprosate : helps maintain abstinence after withdrawal
• Disulfiram (Antabuse): causes an unpleasant reaction when consumed; used in certain motivated patients
• Topiramate and other second-line options
• Assessment of the’indication, contraindications, and follow-up by a doctor
• Coverage variable by the RAMQ and private insurance companies

Psychotherapeutic Approaches

• Cognitive Behavioral Therapy (CBT) specific to addictions
• Motivational Interviewing and brief approaches
• Approaches to relapse prevention
• Therapy couples or family
• Therapies for group
• Approaches based on mindfulness
• Available on the network public and in private practice

Support Groups

• Alcoholics Anonymous (AA) : a 12-step program, meetings throughout Quebec, free
• Narcotics Anonymous (NA) : equivalent for drugs
• Cocaine Addicts Anonymous (CA)
• Anonymous Families, Al-Anon, Nar-Anon for loved ones
• Anonymous Overeaters, Anonymous Playersetc.
• Alternative approaches: SMART Recovery, Refuge Recovery
• Often additional professional care

Alcohol Withdrawal: Caution

• The sudden halt of a heavy alcohol consumption may be dangerous (seizures, delirium tremens)
• Medically Supervised Detoxification often recommended
• Medications such as benzodiazepines in the short term to manage withdrawal symptoms
• Monitoring of complications medical
• Don't don't stop on your own in the event of high daily consumption
• View the doctor, the emergency room, or the CRD

Would you like to discuss this confidentially with a doctor to get started? Omicron Clinic offers confidential medical evaluations, withdrawal support, and referrals to specialized resources at our service locations in Quebec, with teleconsultations available. Make an appointment or opt for the teleconsultation.

Harm Reduction in Quebec

Visit harm reduction acknowledges that not everyone is ready to quit, and that reduce risks Addressing substance use issues saves lives and improves the chances of recovery [6].

Available measures

• Supervised injection sites in Montreal (CACTUS, Street Spectre, The Anonymous One) and in other cities
• Distribution of sterile equipment (syringes, pipes, etc.)
• Analytical Tests substances used to identify contaminants (e.g., fentanyl)
• Naloxone and training
• Advice on safer practices
• Reference transitioning to care when the person is ready
• Support social and psychological

Why this approach?

• Saves lives by reducing the risk of overdose
• Decrease the transmission of HIV and hepatitis
• Create a link with health and social services
• Allows for a shift toward healthcare when the person is ready
• Respect the’autonomy and human dignity
• Approach evidence-based
• Recommended by the authorities Quebec and international public health organizations

Support for Family Members

Visit dependency affects not only the person who uses it, but also their entourage. Resources are available for family members.

What Might Help

• Learn More on addiction as a medical condition
• To speak without judging, expressing concerns with love
• Choose quiet moments, never while under the influence
• Encourage consultation, without imposing
• Knowing the resources to get specific suggestions
• Learn how to use the naloxone so relevant
• Set up your own limits and protect its resources
• Request’help for oneself (loved ones of a dependent person are also affected)

What to Avoid

• Cover the consequences of consumption
• To give’money indiscriminately
• Impose treatment by force (rarely effective)
• Do some morality or make someone feel guilty
• To wear oneself out without asking for help
• To substitute For Professionals
• To hope for a immediate change and sustainable

Resources for Family Members and Friends

• Drugs: Help and Resources 1-800-265-2626 (also provides support to family members)
• Al-Anon, Nar-Anon, Anonymous Families : support groups
• Info-Social 811, option 2
• Care Homes for family members (depending on the region)
• Psychotherapy individual or family
• Employee Assistance Program (EAP) at work, if available
• Organizations local organizations and community groups

Youth and Addiction

A Time of Vulnerability

• Adolescence and early twenties: a period of developing brain
• Risk higher to develop an addiction at an early age
• Introduction early onset associated with a poorer prognosis
• Vulnerability to multiple substance use
• Often associated with challenges mental health or social and family-related issues

Resources for Young People

• Tel-jeunes 1-800-263-2266 (toll-free, confidential, 24/7)
• Kids Help Phone 1 800 668-6868
• Open Area for ages 12 to 25
• Youth Centers and School-Based Services
• Programs specialized in youth addiction treatment facilities in several CIUSSSs
• Foster Rehabilitation Center, programs for teenagers
• Approaches family-related often recommended

Myths and misconceptions

«Addiction is a lack of willpower.»

False. Visit dependency is a medical condition with documented changes in the brain. Willpower alone is generally not enough. The treatment combines medication, therapy and social support, as is the case with other chronic diseases.

«You have to hit rock bottom before you can get help.»

False. There is no no threshold to achieve. An intervention early improves the prognosis. The sooner you seek medical attention, the better. The brief interventions at an early stage are particularly effective.

«Substitution treatments are about replacing one addiction with another.»

False. Visit methadone And the buprenorphine are proven treatments that reduce mortality, street drug use, and infections, and improve quality of life. They are not «one addiction replacing another.» They are medications, just like insulin for diabetes.

«Supervised injection sites encourage drug use»

False. Visit studies show that these sites reduce fatal overdoses, infections (HIV, hepatitis), injection-related waste in the community, and are increasing referrals for care. They do not create new demand; they sauvent lives among people who already use drugs.

«A relapse is a failure.»

False. Visit relapse is often part of the recovery process, just as it is for other chronic conditions. Each attempt learns something. The important thing is to get back on track without excessive guilt, with the support of resources and loved ones.

Frequently asked questions

Is a doctor's referral required to access public services?

In the in most cases, no. Public addiction rehabilitation services can be accessed directly by calling CIUSSS/CISSS, at the CRD or via Drugs: Help and Resources. A reference may be helpful for certain specific purposes but is generally not required.

How long does treatment last?

That varies depending on the substance, the severity, and the response. Initial withdrawal may last a few days several weeks. The rehabilitation and the follow-up may extend over several months to several years. For opioids, treatment with agonists (methadone, buprenorphine) is often long-term. Since addiction is a chronic condition, a long-term follow-up improves results.

Will my employer be notified if I use this service?

No, in most cases. The services are confidential. The doctor and the other healthcare providers are bound by the professional confidentiality. The only situation in which disclosure might be necessary is when there is immediate danger. If you're using a PAE, check the specific privacy policy.

What if I consume «just a little more than average»?

A brief intervention can be very helpful in the early stages, before addiction sets in. Drugs: Help and Resources can help assess the situation. The guidelines Canadian guidelines on low-risk alcohol consumption are available and helpful for getting a sense of where you stand. It is not never It’s not necessary to wait until you have a «real problem» to seek help.

Can cannabis be addictive?

Yes. Environment 10 % for consumers cannabis users develop a substance-use disorder, and even more so among those who started at a young age or who use it daily. The withdrawal symptoms may include irritability, anxiety, sleep disturbances, and loss of appetite. A consultation can help assess and reduce consumption.

How can I help a loved one who refuses to seek help?

Do not to insist excessively, which can be counterproductive. Maintaining a respectful relationship, express one's concerns without judging, share resources and remain available. Drugs: Help and Resources and support groups for family members (Al-Anon, Nar-Anon) provide valuable support. It is also necessary to protect oneself and maintain one's own health.

Sources

1. Drugs: Help and Resources. Hotline: 1-800-265-2626 and chat.
2. Quebec Association of Addiction Professionals (AIDQ). Information on Addiction and the Quebec Network.
3. American Psychiatric Association. DSM-5 — Criteria for Substance Use Disorders.
4. MSSS — Ministry of Health and Social Services. Quebec Addictions and Services Program.
5. INESSS — National Institute for Excellence in Health and Social Services. Guides and Reviews on Treatments for Opioid and Alcohol Addiction.
6. INSPQ — National Institute of Public Health of Quebec. Overdose Surveillance and Harm Reduction.
7. Canadian Centre on Substance Use and Addiction (CCSUA). Guidelines and National Information.

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