There is no easy access to the mind of the alcohol and drug addict and there is no one-stop shopping for treatment.
Counsellors Garry Tedford and Pat Ottesen have pretty well seen it all when it comes to addictions and their victims.
Ottesen is manager/counsellor for St. Joseph's Hospital Addiction Services while Tedford is supervisor of Addiction Services for the local region in the Sun Country Health Region.
Ottesen has been dealing with the alcohol and drug world for over 20 years, including seven with the Swift Current Youth Counselling Services and in rural areas in Saskatchewan before returning to Estevan in 2006, the city where she started her counselling career.
Tedford has been engaged in counselling services in southeast Saskatchewan for 27 years.
The growth in problems connected to liquor and alcohol addictions is significant and the two counsellors agreed they are definitely more complex these days.
The victims are much younger, generally speaking, and there is a larger diversity in trends.
There is a whole new world of crossover drugs that just weren't part of the problem years ago. They're called concurrent disorders in professional terms, but what it means is that an alcoholic may quite easily be dealing with not only the liquor addiction, but also a drug addiction and mental health issues.
Availability of drugs is a factor.
"It's almost as if this combination thing going on is socially acceptable," said Ottesen.
"Then you'll have the unpredictable behaviours. Or someone will think they're cleaning up because they've stopped using cocaine and they're just using marijuana," she added, shaking her head.
"I guess what we're saying is that attitudes, complexities and crisis situations are growing," said Tedford.
"Read the police reports. There used to be one case reported in a week, now there are seven to 10 or more. I'm sure Estevan police will have a lot to say about the local situation, they're on the front lines," Tedford added. "Used to be two or three bar fights, now there are seven or 10."
As far as being socially acceptable, Ottesen said drug users are getting even more brazen.
"Cocaine in the bathroom, marijuana in the parking lot no big deal. Cocaine party later on. I'm surprised at those numbers, but maybe I shouldn't be, not with the availability of money around here. There's a much higher level of disposable income and it shows up in our statistics," Ottesen said. "We have clients with jobs that pay $150,000 a year, and they're broke, thanks to drugs and liquor."
St. Joseph's Hospital had 181 alcohol-related clients who had issues that created problems within the 2012-13 year, and another 19 that didn't create a major issue. They also dealt with 99 marijuana use clients, 46 crack/cocaine victims along with another 19 who were dealing with stimulants or prescription drugs and seven who were ingesting hallucinogens.
Then there is the world of those who become dependent on anti-depressants, sedatives, tranquillizers or steroids.
With just one and a half counselling positions available to deal with the problem at the hospital level, it becomes a full slate. Ottesen said they handled 284 clients.
The average wait time for outpatient assistance can be 18 days.
An emerging problem with addicted clients are the people who have arrived in Estevan from well outside the community and they have no supportive environment to call on as they struggle to re-emerge on the other side of treatment.
"Or they're here because they wanted to get away from the problem. We call that the geographical cure. They say to themselves that 'if I get away from here, that'll solve my problem,' but really there is often nothing specific that leads to the problem in the first place."
Tedford added, "but let's dispel the myth that this whole problem is because of transient people they're the ones causing the problem. Sure there are some, but we have some good chronic home-bred problems within our long-time citizens here, so let's not hang this problem on one group. If you're chemically addicted, you are impacting others and that's what we're trying to combat."
Crossover addictions are natural occurences in Estevan.
"Some addicts don't even know what they're using. A couple of years ago, crystal meth was out there, but that's down now. I think we've handled only two instances this year and none the year before, but then there's marijuana, crack cocaine, alcohol and ecstasy and we have some problems with people using stimulants or prescription drugs. So it's an interchangeable world here," said Tedford.
Social detoxification centres closest to Estevan are in Regina and Moose Jaw. Physical detoxification is done in hospitals, prepping the victims for ongoing treatment, usually as an outpatient.
"They are treated for dependency through outpatient addiction services that offer community-based recovery processes. The second option is the social detox in a centre," said Tedford.
"The medical detox happens if they have a condition that can't be handled in a social detox centre. They need to see a doctor, they need to withdraw. It could be two or three days, then on to the social detox program. We help them manage the condition."
Tedford said the parallel psychiatric services coverage in Sun Country is good at present. Mental health services might need to get involved in the program, or a social worker needs to be assigned to help the client stabilize into recovery mode.
A social detoxification process can absorb as many as seven to 14 days, depending on location of services and circumstances. Residential and inpatient community services are also there.
There are no solid follow-up programs and high relapse rates prove to be a problem. "It gets down to where do we put them until an inpatient bed is available?" said Tedford.
Alcoholic Anonymous and Narcotics Anonymous really step up and help in those instances, he said.
There are transitional housing accommodations in Estevan, said Tedford. The two and three bedroom apartments, with staff, provide supportive housing for those who are relapse prone or those with unstable support systems.
"But they have to complete the recovery program first and that can be up to a year. But I will say, the provincial government has been good at providing funding for this program," said Tedford.
Tedford added Sun Country provides 2.5 counselling positions at the local level but sometimes that gets thrown off track when schedules get tested.
A psychiatric unit in Weyburn is available for difficult cases, the ones that Tedford described as "those 3 a.m. calls the police get," after that, the counsellors get the calls contact their new client and work begins.
In a perfect world, the local program could definitely use more inpatient beds and another social detox centre is needed in southern Saskatchewan, or at least more beds in the existing facilities because the local counsellors feel more inpatient treatment would help ease the problem.
"Sometimes I feel it's getting frightening. People just seem to be getting the alcohol and drugs but not getting it in terms of normalizing situations, especially the youth, and of course, I'm not painting all youth, just the ones who have problems with it."
Tedford went on to conclude, by saying "Estevan isn't filled with drunks and addicts, but it is a growing problem. We have a strong-minded community, so we can deal with it if we want to."
Ottesen added, "It's better here than what I was dealing with in Swift Current. While I was there, it was a meth problem, kids going to raves in Regina and coming back with real problems with meth or ecstasy some would still be high or just been raped. So it's not exclusive to Estevan."
Both counsellors were quick in their praise of police services in both Estevan and Weyburn. They said the way they handle the intoxicated or drugged personalities continues to be very professional and very efficient. So that alone, helps them begin their work with clients. Relationships with mental health professionals have improved significantly over the years, giving everyone an additional tool and additional help when it is needed most.
So is the strong-willed community of Estevan going to turn that strength into feeding bad habits or will it be turned into treating them?
Time will tell and time is also of the essence.
