montreal anglos left with fewer addiction treatment options after shakeup

as the crises of addiction and homelessness deepen, montrealers looking for inpatient substance use treatment in english have suddenly seen their options narrowed because of a bureaucratic change among regional health agencies, says an association representing non-profit treatment centres in quebec. on april 1, the recently renamed santé québec centre-sud-de-l’Île-de-montréal — universitaire, the agency that manages addiction treatment across the island, repatriated responsibility for english-speaking montrealers from its counterpart serving the montérégie-ouest region on the south shore.english speakers in montreal have been absorbed by a rehab system on the island that already didn’t offer francophone clients the varied residential treatment options and extended stays that are available to francophone and anglophone clients of the montérégie-ouest health agency, said bruno ferrari, of the association québécoise des centres d’intervention en dépendance (aqcid). he is president of the association's standing committee on treatment.the difference is that the agency on the south shore, which was known as the cisss de la montérégie-ouest (cisssmo) before a name change this year, has contracts with numerous non-profit treatment centres that offer a variety of residential rehab programs, whereas montreal’s centre-sud agency, formerly known as a ciusss, does not contract out rehab.the centre-sud agency handles rehab “in-house,” in a government-run centre on the island that has 55 beds and a 21-day inpatient treatment program, as well as offering outpatient services. “on april 1, anglophones in montreal lost the option to have access to english services that were available under contract with the cisssmo,” said ferrari, who is also executive director of vilavi, a bilingual non-profit treatment centre in terrebonne. “the cisssmo guaranteed services. it was an obligation to answer anglophones from montreal, evaluate their situation and offer services that met their particular needs. now those services don’t exist and the centre-sud (agency) didn’t enlarge the services in montreal. so i see a clear loss.” the repatriation of english speakers in montreal follows the closure of the foster pavilion in st-philippe, just south of montreal, which for years served as a specialized inpatient addiction rehab centre for anglophones in the greater montreal area. historically, english speakers with addiction problems in montreal were referred to the south shore for evaluation and placement because the foster pavilion was located there.

montreal’s english-speaking clientele is now being admitted into one of the pavilions of the public centre de réadaptation en dépendance de montréal (crd), which has 10 service points on the island. the pavilion, on prince-arthur st., operated in french before the transition and has become bilingual since april 1. from april to late june, the pavilion admitted 25 english speakers, the agency’s communications team said in an email. ferrari contends that 55 treatment beds aren't enough for montreal francophones and anglophones. “it’s obviously not enough,” he said. “it makes me laugh.” on top of that, an addiction psychiatry program at the mcgill university health centre was closed at the end of 2024, he noted. however, the centre-sud agency maintains that its beds and its outpatient services can handle the additional clientele. “the number of available places remains unchanged,” the agency’s email said of the 55 inpatient rehab beds. “english-speaking clients, previously served in the montérégie region, now benefit from improved access, closer to their place of residence.” the agency also says the wait time for a bed at the crd is relatively short: 15 to 21 days. the most critical cases are prioritized, it says.in addition to the inpatient rehab beds, the agency says it has 10 emergency stretchers and offers eight spaces from an external resource for individuals needing a stay beyond the 21 days in the crd. it also contracts out 10 post-rehab social reintegration spaces. francophone — and now anglophone — montrealers can try to get admitted to non-profit treatment centres on their own, ferrari noted. but in general, adults have to be on welfare for the government to allow them free access. some have insurance that will cover some part of the cost. otherwise, they have to pay the full price of thousands of dollars a month. ferrari contends free access to inpatient non-profit rehab centres is hampered for both language groups by inadequate provincial funding for non-profit treatment centres.meanwhile, the drug crisis is compounded by a dramatic increase in the unhoused population since covid. homelessness, mental health and addiction are interconnected, notably as people use drugs or alcohol to numb pain and cope with trauma, cold and fear.the latest data shows the number of visible unhoused people in quebec rose by more than 20 per cent between 2022 and 2025, to 12,077. in montreal, they now number 5,789. in mid-july, the montreal public health department said it had seen an increase in non-fatal overdoses in the city over three to four months, as well as 22 overdose deaths in june and 13 in the first half of july. there were as many ambulance interventions for overdoses in montreal from january to mid-july as for all of 2025, the department said.the coalition avenir québec government refused to comment. lionel carmant, the minister for social services and the fight against homelessness, and christopher skeete, the minister responsible for relations with english-speaking quebecers, declined to be interviewed. carmant and skeete’s spokespeople referred questions to the health ministry. health minister sonia bélanger’s office referred questions to carmant.ferrari says the only model that works well, and appears to be unique in quebec, is the one developed by montérégie-ouest. the public crd under the responsibility of montérégie-ouest provides outpatient services and drying out, and also funds non-profit treatment centres to provide inpatient recovery in french and in english.the agency has contracts with places like vilavi and dunham house, an all-english facility in the eastern townships that is one of the few centres operating in either language in quebec that treats dual-diagnosis addiction and mental health disorders.

montérégie-ouest spokesperson Étienne beaudin said in an email that the agency contracts out “to provide a diversified” offer of services adapted to individual users’ needs. the montérégie-ouest agency doesn’t require its clients to be on welfare to be treated at a non-profit residential rehab for free.montérégie-ouest pays a fair daily rate for the clients it refers to those rehab centres, ferrari said. moreover, its rate is indexed annually, he said. “they are asking the centre to provide a service that the public network is not able to provide, such as a longer stay and activities that are too expensive for the government to provide,” ferrari said. “non-profit community organizations are able to provide these at a reasonable cost. and it’s no risk to the cisssmo because they only pay a centre if they send an individual to them.” one size does not fit all in addiction treatment, so it’s beneficial to have a variety of options with different treatment approaches, he added."it’s a real partnership with the cisssmo, combining all our strengths,” ferrari said. "we don't understand why a model like that isn't just put everywhere in quebec. it would cost less for everyone.”