Showing posts with label addiction. Show all posts
Showing posts with label addiction. Show all posts

Friday, March 20, 2009

Hip, hip, hooray - Woodwynn Farm's going forward

Hey, could this be hope I’m feeling? It’s such a hard thing to hold onto amid the gloom and doom of the day, but this past week I started to notice a distinct cheery bonhomie creeping over me. I’d almost forgotten how good it feels.
It started last Wednesday, after I toured Vancouver’s terrific new emergency housing for people living hard on the street - the so-called “hardest to house. “ It’s a label that calls up scary images of people beyond help, but the Vancouver experience - set in motion by a committed city council focused on homelessness - is rapidly disproving the myths of that (more on that in a future column).
And then this week, it was over the moon for me when I got the news that Richard LeBlanc and his team were successful in their bid to buy Woodwynn Farm.
Chalk one up to instant karma, which LeBlanc has surely earned after a particularly hard year of trying to acquire Woodwynn in the face of a fierce NIMBY campaign fought by neighbouring landowners. His work heading up the highly successful Youth Employment Society a few years back stands as proof of his passion and competence, so it’s a major win for him and our community that he has been successful.
LeBlanc’s plan for Woodwynn is to have it up and running by this fall as a therapeutic community for people looking for a new lease on life and a way out of pain, addiction and homelessness. The original plan was that people would live on the farm, but that got nixed last year when Central Saanich council ruled it out before LeBlanc could even ask them about it.
So now, people will work at Woodwynn but live elsewhere (location still to be worked out). There will be 24 people to start, and as many as 96 as the program builds over the next three years. They’ll be doing what you’d expect people on a working farm to be doing: tending the land and the animals; growing food; learning new skills; launching into the world to start their own businesses. Along the way, they’ll rebuild their lives.
It stuns me that anyone can find that controversial.
The group that opposed LeBlanc - Farmlands Trust - positioned itself as a preservationist group that simply wanted to ensure Woodwynn remain a farm in perpetuity. That’s the reason on the record for why the Trust tried to buy the 68-hectare property out from under LeBlanc’s group last spring, and has fought him like the encroaching enemy ever since.
I guess we all tell ourselves stories to help us to sleep at night. No doubt some members of the Trust do want to preserve farmland, but the group didn’t even try to keep a lid on the members whose main agenda was to shut out LeBlanc and his “homeless farm.” Their true colours leaked out often enough that I came to form a somewhat different picture of the Trust’s efforts.
Seeing as LeBlanc only wanted the same thing that Farmlands Trust ostensibly wanted - to maintain Woodwynn as a working farm - surely at least a few members of the Trust are celebrating with him this week in the achievement of their common goal.
Hopefully the Trust reflects on what it means to have found common purpose with those whose uninformed, ugly opinions surfaced over the past year with each flurry of media interest in LeBlanc’s project. How did a farmland-preservation group end up so far from home?
Hopefully the members of the Trust are gracious in defeat, and just get out of the way so LeBlanc can try to do a good thing. I think the disbelievers will be pleasantly surprised at how much a person in tough circumstance looks just like anybody else once they’ve got a place to go, a community to help them get there, and a fresh set of clothes.
LeBlanc and his organization, the Create Homefulness Society, have a tough road to travel still, of course. The purchase of Woodwynn happened because a few generous people in our region anted up for his cause. They’ll want to be paid back sometime in the next five years.
Then there’s all the work that will have to be done to raise money for operations. That’s never easy. For better or worse, the society can also expect to be thrust into the ongoing debate around homelessness - and on occasion, find itself the lightning rod for our fears and misconceptions.
But that’s for later. For now, let’s just celebrate that the good guys won.

Friday, March 13, 2009

Detox rules work well for some - so let's do it both ways

Speaking up for the rights of one group invariably means stepping on those of another, as I was reminded following my recent column on the no-smoking policy at the new detox.
An old acquaintance of mine - I’ll call her Shelly - phoned me after the column appeared to tell me I was wrong to be critical of Vancouver Island Health Authority staff for prohibiting smoking at the detox. She’d arrived for a stay at the brand-new unit last month prepared to hate the prohibition, too, but instead quit smoking - for the first time in more than 40 years.
She was proudly 28 days nicotine-free when I met up with her last week at the Pembroke Street stabilization unit, which is where people fresh from detox ideally get to stay for a month while they work out the details of a life without drugs. Shelly had gone to detox primarily to get off heroin, valium, alcohol and cocaine, but was delighted to have gotten out from under her cigarette habit at the same time.
“I brought a carton with me when I came, because the word on the street was that you could smoke in the bathroom,” says Shelly, the fourth patient through the new detox after it opened in early February. “Then they told me no. I thought, God, I’m never going to be able to do this. I was asking for the [nicotine] patch within a couple hours. But then I did fine.”
My concerns with the no-smoking policy continue - and indeed, Shelly saw a fellow patient get kicked out of detox after being caught smoking. How crazy is it to deny people urgently needed health care just to make a point about the eventual dangers of cigarette smoking? There’s also a gap a mile wide in the system for adults addicted to cocaine or crystal meth, who for the most part are not accepted at the detox.
That said, far be it from me to deny Shelly the very positive experience she had at the detox, partly as a result of not being allowed to smoke. Being in a stable, smoke-free environment - lots of support, lots of nicotine patches - was really beneficial for Shelly, who looks happier and healthier than I’ve seen her look in years.
A solution, then: A medical detox, smoke-free, for people like Shelly - people whose primary drugs are opiates or alcohol and who need the more intense medical care the new detox provides. And a different kind of detox somewhere else, one where people can get help regardless of the drug they’re addicted to and not have to give up smoking at the same time. Nothing expensive or fancy - just a practical, safe place.
Shelly’s latest journey into recovery has been an exemplary one, and worth detailing for what it says about all the things that have to come together to help those overwhelmed by addiction.
It starts with Shelly, of course, because she was the one who went looking for change. But then she had the good fortune of connecting with outreach workers from the Umbrella Society, a very savvy little peer-led non-profit that helps people with addictions and mental-health issues. Shelly had the will, but it was the Umbrella Society that showed her the way.
“Gordon Harper is a large person in my life right now,” says Shelly of the society’s executive director. “I told him that he was going to have to decide where my next move was, because I didn’t have any brains anymore.
“So he set me up with this - detox, stabilization, a recovery home for at least three months, then to Aurora [treatment centre], then back to a recovery home. I’m expecting it will take me a year to do it, but that’s OK, seeing as I’ve wasted eight years using drugs.”
Other things went right as well. Shelly got a rare 18-day stretch in the new detox, almost three times as long as most get. Then she got a bed immediately in the stabilization unit, also not typical. With Harper on her side, she just might make it through the forms, waitlists, phone calls, intake processes, hard work, meltdowns and meetings that await those trying to get help with their addictions.
Shelly says the help is there for those who reach out for it. But I know too many others lost in the fractured system to see her story as the norm. I can’t imagine why we make it so hard.

Monday, March 02, 2009

Health authority's detox rules block access for street users

We met over coffee last week, each with our own reasons for being there.
I was there to find out why the region’s new 14-bed detox unit is virtually unavailable to people from the street community. He wanted to know why the media always fixate on the negative.
We talked for an hour and a half. I’m not sure that either of us fully understood the other one’s points by the end of it all. But at least we heard each other out, and I appreciated his frankness.
As the director of addiction services for the Vancouver Island Health Authority, Dr. Laurence Bosley is an important man when it comes to addressing some of the immense problems on our streets.
Addiction certainly isn’t the only reason why people end up homelessness. But it’s a major reason for why they get stuck out there. So when the health authority opens a new detox with policies that essentially exclude most of the several hundred people with addictions on our streets, I’d like to understand why.
But first to Dr. Bosley’s point about the media, because I do get what he means. We desperately needed the new detox and seven “stabilization” beds that opened this month, and it’s a beautiful facility in a time of scarce resource.
So I understand Bosley’s unhappiness at having media hone in on two “negative” angles on the story: That the facility isn’t available for stimulant users (people addicted to cocaine or crystal meth); and that it goes against the health authority’s own addiction-treatment policy by prohibiting smoking anywhere on site.
But like I told an audience of young activists at the youth-organized Change Conference this past weekend, you don’t fix a hole in the roof by talking about the 90 per cent of it that isn’t leaking. We won’t address what’s wrong in this world without talking about the problems.
Detox is the first step in getting out from under an addiction. It’s essentially five to seven days of care and prescription-drug therapy to help people through the most immediate withdrawal effects of whatever drug they were using.
Bosley rightly notes that it’s a pretty minor step, all things considered. But it’s the first one nonetheless. None of the steps that come after - treatment; spiritual healing; finding new ways to cope; drug-free housing; new friends and places to go; the hard, hard work of staying sober - can begin without detox.
So when policies at the new detox shut out the most prominently addicted people in our region, that’s one heck of a leak in the roof. The dominant drugs on the street right now are crack cocaine and crystal meth, so the no-stimulants rule alone has huge implications. But add in the no-smoking policy for a population for whom tobacco is the sole saving grace of life, and you’ve shut out the people who most need the help.
Bosley applies a cost-benefit analysis to the issue. The health authority has a limited amount of money to spend, and unrelenting demand for all its services. It’s making choices all the time in terms of who’s getting care.
On the detox front, Bosley points out that withdrawing from heroin or alcohol can kill you, and must be done under medical supervision. Withdrawing from cocaine or crystal meth is unpleasant, but not life-threatening. VIHA’s mandate is to provide medical care, not to give away expensive beds to people who really just need a place to lie down and sweat it out.
Except people on the street don’t have a place to lie down. No bed to sleep in for five straight days, that’s for sure. No way to get away from the sellers and the users. No place to detox, and thus no way to even begin the long journey out of addiction.
Bosley also notes that it makes little sense to give someone who’s homeless a detox bed for five nights and then just release them back to the streets. On that point we definitely agree. He wonders if we try too hard to “cure” everyone, when some people’s problems simply may not be curable.
I would argue that we’ve barely tried at all in terms of the street community. The significant successes of the three VIHA-led integrated outreach teams in keeping people supported and housed this past year underline how much can be accomplished when we do get down to the business of dealing with people’s real needs.
As for smoking, Bosley says he can’t believe anyone is surprised at that decision: “That’s just good clinical care.” I guess I see it as picking your battles. What good can come of denying people care for their addiction just because they can’t quit smoking?

Sunday, June 08, 2008

Insite not the answer, but it helps
June 6, 2008

Perhaps you’re already familiar with that ancient fable about the six blind men and the elephant. I find it coming to mind a lot these days in the fight over Canada’s only supervised injection site.
The Indian fable, put into charming verse in 1873 by John Godfrey Saxe, tells the story of how the six men interpreted what an elephant looked like based on whatever part of the elephant’s anatomy they touched first. One touches the animal’s massive side and concludes it must resemble a wall; another grabs the trunk and presumes that elephants are shaped like snakes; and so on. (http://www.noogenesis.com/pineapple/blind_men_elephant.html if you’re curious).
The point I’ve always taken from the fable is that it’s impossible to reach the right conclusion if you presume that what you know is all there is to know. Problems are solved not by bickering over six different versions of an elephant but by bringing those viewpoints together to understand the whole.
It’s pretty clear from the battle shaping up around Vancouver’s supervised injection site that we’ve got an elephant on our hands. Blinkered by an ideological viewpoint that simply doesn’t allow for a fuller picture to emerge, the federal government has a tight grasp of the elephant’s tail and an equally firm conviction that its version is the only one that matters.
We can fight it out in court, I suppose, and that appears to be what we’re headed for. A win in B.C. Supreme Court last week that deemed the pending closure of Insite unconstitutional is headed for appeals court and no doubt the Supreme Court of Canada now that Ottawa has made it clear that its sole goal is to shut Insite down.
I suspect last week’s ruling will ultimately be upheld. But for the 8,000 users of Insite who face being hung out to dry for the next decade while we argue about what constitutes an elephant - not to mention tens of thousands of other Canadians who could benefit from similar sites in their own communities - I can only hope for a much quicker resolution than a court fight will ever bring us.
My personal view of places like Insite is that they’re a small but important component of an overall strategy for reducing the harms of drug and alcohol use.
They certainly don’t solve all of the problems around addiction, or even most of them. Nor are they universally supported by people with addictions in their own background, some of whom are every bit as adamantly opposed to injection sites as the Conservative government.
But supervised injection sites do keep people alive to fight another day. They bring a desperate and isolated population into contact with professionals who want to help them. They provide health care to a group of people who otherwise receive very little due to widespread stigmatization of their particular illness.
They reduce the spread of costly and difficult diseases. They provide a badly needed alternative to open drug use on our streets by those too addicted to hide their problems any more. Meanwhile, as has been proven at Insite, they don’t lead to increased street problems or higher rates of crime. That’s good enough for me.
The government questions whether the dire situation in the Downtown Eastside has improved at all since the site opened four years ago, and contends that Insite’s $3 million annual budget would be better spent on “treatment.”
Federal Health Minister Tony Clement is absolutely right when he says much more money needs to be put toward treatment for addictions. But for many of Vancouver’s most disadvantaged users, Insite is where treatment starts.
For some, a visit to the supervised site will be a first step toward recovery. I don’t know how Clement envisages people with severe addictions finding the help they need to begin that journey, but in my experience it starts with them getting support in a place where they’re accepted just as they are.
For others, recovery will be years in the making, perhaps even unachievable. But at the very least they will benefit from a safe, clean place to inject, and our communities will benefit from a reduction in the ferocious bacterial and viral infections spread through street-level injection drug use.
As for fears we’re sending a “poor message” to youth about drug use by allowing supervised injection sites, that’s just one of those fictions that lazy people dream up to create emotional heat around an unsound argument. Nothing says “Kids, don’t do drugs” better than the haunted visage of someone in late-stage addiction.
With as many as 125,000 Canadians thought to be injecting illicit drugs, the elephant is upon us. Time to open our eyes and see the beast for what it is.

Friday, March 21, 2008

Family devastated by late-life addiction
March 21, 2008

We pull up kitchen chairs in her little bachelor suite, and she apologizes for not being able to offer a more comfortable seat. It’s a tight fit for two in the tiny seniors’ apartment.
She’ll soon be 77, and up until a couple years ago believed that she’d reached a point in her life where things had more or less settled out. With her seven kids grown up with lives of their own, she was looking forward to an uneventful old age.
Her first sense that she might be wrong about that was at the family’s annual campout in 2005. Her 46-year-old son, always a bit of a hothead, flew into a fit of temper of grand proportions. Another son told her the problem was cocaine.
She didn’t believe it at first. But then relatives came from Australia to visit that same year, and her son showed up looking sick in a way that really alarmed her. “That’s when I started to wonder,” she acknowledges now.
As it turned out, her son had developed a severe addiction to crack cocaine. She doesn’t know when or why he started using the drug, but by that summer his problems were frighteningly obvious.
It’s been a hard ride down ever since. In short order, the man lost his wife, his four kids, and his job. He lost his house - sold off as part of the divorce - then blew every cent of his share of the proceeds on crack.
He hasn’t yet fallen to the streets. But that’s only because one of his sisters simply won’t let that happen, even if it means going down to Centennial Square herself time and again to bring her exhausted, sick brother home to her house.
Desperate to help him, the family scrounged up $37,000 for a month of treatment at a private addiction facility. He was a “star” participant while in the program, says his mom, but relapsed shortly after getting out.
She knows there has to be an explanation for how her otherwise straight-arrow son fell headlong into the abyss. He was working too hard, she suspects. He’s got some ghosts from childhood that she only recently found out about.
Still, she admits she didn’t see any of it coming.
“Of all of us, he’s always been the one who drinks the least,” she says. “I can’t understand why he ever would have tried crack - he doesn’t even smoke.”
“All his life, he’s held down a job, and sometimes another small job on the side, too. He’s a bright, intelligent man - even now, we’ll meet for lunch and I can’t believe how quick and bright he is. And he’s a wonderful father.”
She’s heard conflicting advice from friends and family about how to handle her son’s addiction. Some have told her that she’s “enabling” him by giving him money and rescuing him from the streets. Their theory is that addicts need to hit bottom before they get well, and that she’s preventing her son from doing that.
But she can’t imagine withdrawing her support. “You remember that old saying from the ‘70s about how if you loved someone, you’d set them free?” she asks. “I think for addicts, if you love them, you never set them free.”
Her other children are sharply divided over how much support their brother deserves, and upset at the chaos and stress his addiction has caused within the family. The annual family campout hasn’t happened since that fateful summer when her son lost his temper.
“Nobody can possibly understand how addiction impacts a family until it’s them,” says the woman, who has dipped heavily into her retirement savings in an attempt to help her son.
“You can’t imagine the sleepless nights I have. I’ll lie in bed thinking of all the things that could be happening to him. To know he’s out there, where bad things are happening all the time - I just don’t know what to do.”
So she holds on, hoping against hope that a mother’s full-on love will be enough.
She tells a story of her daughter going down to the streets one morning to rescue her brother yet again, and of how long it took to rouse him from his deep, dark sleep. The people he was with - all in the grips of their own addictions - watched in silence as his sister repeatedly called his name.
“Nobody said anything,” the mother recalls, “but my daughter was struck by the feeling that all of them wished they had somebody to come for them, too. All these men out there, so lost.”

Sunday, March 09, 2008

"Temporary" food bank sees no end in sight
March 7, 2008

Noon is approaching, and the lineups have slowed to a trickle. The little food bank at St. John the Divine Church closes at noon, so the regulars know to come early.
Anne Henderson is one of several St. John congregation members who volunteer at the church’s food bank every Tuesday and Friday. A 10-year veteran of the work, Henderson admits to feeling increasingly discouraged.
“Seeing the young people is hard,” says Henderson. “They come in looking like relatively nice kids, but they’ve obviously got pain in their lives. They can’t get any income assistance because they have no work history.
“Pretty soon, they’re into the drugs because of their pain. Six months later, you see them in here looking so lost.”
The food bank was intended as a temporary measure in a time of crisis when it first started. But 15 years on, the need has only grown. “We’ve all gotten a little older, a little more tired, and a little shorter of money,” says Henderson, whose church runs the program on donations.
Today has been slower than usual. Henderson suspects that’s because of a recent visit to the office of Employment and Income Assistance Minister Claude Richmond.
Church members were there to make a point about impossibly low welfare rates by bringing it to Richmond’s attention that his own ministry was handing out information sheets directing clients to go get food at the church. But all that did was prompt the ministry to quit telling people about the food bank.
People can come to the food bank once a month to pick 10 or 12 items from an eclectic list of 60 or so household goods the church keeps in stock.
Today’s list runs the gamut: green beans; dog food; coconut milk; toilet paper; artichoke hearts.
“We really try to respect choices, and to let people choose the food they want. They can let us know if they’re on a special diet and we’ll try to work with that,” says Henderson.
Henderson has met all kinds at the food bank. One client was a former government employee who couldn’t get her feet back under her after losing her job in the “purge” after the 2001 election.
“She was on Employment Insurance for a while, but that ran out and she ended up on welfare. In the end, she couldn’t afford to keep her apartment,” recalls Henderson. “She told me she never in her life imagined she’d get to this point.”
At the table where people check in, a 52-year-old window installer tells us of breaking his wrist helping a friend put up Christmas lights. He’s scratching by for now on “medical EI,” but wondering what will happen if his year of support comes to an end and his wrist still isn’t strong enough to go back to his old line of work.
I recognize another client from my time last fall gathering information on street issues for a Times-Colonist series. I have a haunting photo of him from that period, packing up his stuff in the dark of early morning after the police arrived to move him along from a Fort Street doorway.
He has since found a place to live, thanks to a stranger who spotted him a couple months ago at the Upper Room soup kitchen and offered help with getting on disability and finding an apartment.
“I’d been on the streets 10 years,” he tells me. “I’ve got a mental thing going on, and find it hard to deal with people. But this time I feel like I’ve got somebody backing me. The doctor put me on medication to settle my mind down, and that’s helped a lot, too.”
Henderson polled her fellow food-bank volunteers in anticipation of my visit, and hands me a sheet of their written comments.
One expressed surprise that the people who attend aren’t angrier at their desperate situations. Another recalled a grateful client who found a way to burn a few CDs of Christmas music to sell on the street as a way of raising money for the food bank. “I am touched by the support they offer each other,” noted another.
“We all know that people on social assistance can’t buy a nutritionally adequate diet,” one of the writers summed up.
“It is sad indeed to see pale, haggard faces and bad teeth, and know that we are only able to offer food for a day or two - and to know that these people will only get sicker.”


Recovery sparks drive to do more for others
Feb. 29, 2008

By the time Thea dragged herself into the health authority’s drug and alcohol centre on Quadra Street in November, she was drinking so heavily that death was looking like a terrifying possibility.
The 35-year-old was knocking back a bottle of vodka, two bottles of wine, a six-pack of coolers and a bottle of Baby Duck every day by that point. “And using heroin and crack on top of that,” Thea recalls. “If that’s not a cry for help, what is?”
What she needed was a detox bed. What she got was an appointment for two months down the road to see a drug counsellor, who would then decide whether to refer her to one of the region’s scarce detox placements.
“I told the guy I didn’t have two months - hell, I didn’t have two hours,” says Thea. “But it didn’t change anything. I remember crying on the phone to my friend, telling her, ‘They can’t help me.’”
That night, Thea called her sister in Chilliwack and begged to use her address in order to fake her way into a detox bed at the Chilliwack hospital for a week. Four days later, she got one.
She’s been mostly clean and sober for a shaky eight weeks now, and is back in Victoria living with a friend. And she’s got a pressing new cause: More treatment services for people with addictions.
“Yes, we’ve made a choice to do dope. But shouldn’t we have the choice to get help?” she asks. “We don’t have that choice, so we end up choosing to keep doing dope. Choosing to vandalize to be able to pay for it. Choosing to work the streets.”
Addicted for 10 years and “hard core” for the past two, Thea has paid for her habit through sex work and petty crime. Recently sentenced to do community hours at Our Place street drop-in, she discovered that the work was igniting a passion in her to help people with addictions get treatment.
“I love it there, but I’m seeing so many people wasting away. It’s sad to see - all these young guys, early 20s, and they already look like shit,” says Thea. “I can’t imagine what they’re going to look like at my age.
“One day I started asking everyone I saw in there whether they’d go to residential treatment if it was available. Only one person said no. The reality is that there’s nowhere to get help. Nowhere. I can’t emphasize that enough.”
The streets have become significantly meaner in the last couple of years, says Thea. She worked a corner on the Rock Bay stroll during much of her time on the streets, but says she wouldn’t do it anymore now that the drug dealers have moved in.
“They took out the pay phones down there because they didn’t want people calling their dealers. But the girls aren’t going to walk five blocks to find another pay phone, so the dealers are now coming to the girls,” she says.
“That means that crime’s going up down there and the cops are around all the time, which jeopardizes everything for the girls. You’ve got guys on bikes selling $5 rocks (of crack cocaine). The johns think the dealers are pimps, so they’re not happy, either. And now I’m hearing of guys from Vancouver coming over to try to run things.”
Like many people with addictions, Thea ended up disconnected from her family during her ride to the bottom. She’s working hard to turn things around, but notes that it took her father being in a serious motor-vehicle accident in Vancouver to bring her back in touch with her family, including her 14-year-old daughter.
“I don’t want to go back. I don’t want to lose contact with my daughter again,” says Thea. “I did my rock-bottom. I’m not totally cured, but I’m OK, and I want to make a difference.”
Her immediate plans are for a petition calling for residential treatment and more detox beds. She’s also getting involved with the Greater Victoria Commission on Homelessness, which has a working group of people with personal experience on the streets.
“I used to be so proud of Victoria. But when I think of it at night now, I don’t think of those 3,333 lights on the parliament building, I think of drugs and crime,” says Thea.
“It’s like a lifestyle is starting to happen out there. It reminds me of Hastings Street. We’ve really got to do something to help people get out of this.”