This past Thursday, I brought a motion to help people get into the Detox-Treatment-Recovery System. The motion will be decided upon later during budget deliberations, but here’s a quick outline of the need and how it could work.
The need
According to front line service providers, the large majority of the people you see on Pandora are suffering from substance use disorder – addiction to drugs that are very harmful. Some of these people are homeless, but not all. Many also suffer from other forms of mental illness, trauma, etc.
People can get out of addiction by entering into the detox-treatment-recovery pathway. As part of its Road to Recovery Plan, BC is expanding that pathway; it has opened 758 new publicly-funded treatment and recovery beds since 2017, bringing the total to 3,778 beds.
The whole system, including secondary and tertiary housing for people coming out of treatment, needs to expand further, but the pathway exists and people across the province are using it. Some people in Victoria access the system here on the island, and some go over to the mainland, for instance to the Redfish Healing Centre.
Too many are exiting addiction through death.
I think we can all agree that we want people to enter into the detox-treatment-recovery pathway. However, entering that pathway is not always easy; many people on the street have serious challenges doing basic things. Some have a hard time walking half a block to get medical attention. Some can’t get themselves food. Front line service providers have told me of the steeply increasing acuity of the victims of addiction, even just in the last five years. This is caused by the worsening characteristics of the toxic unregulated drug supply, and by cognitive losses arising from repeated anoxic overdoses and other brain injuries.
I tested the system for getting into detox. I searched the web, and found a number of websites, and a very large amount of information. It was not quick or easy to find determine how a person in Victoria gets into the pathway. Help Starts Here was one of many websites I found, and if you scope down your search on that site to addiction, and to Victoria, it takes you to a map with 40 or 50 links. And that’s just one of the many websites.
I also made phone calls. I called one number, they told me to call another, who told me to call another. This is of course a familiar story for anyone who has tried to access a large system. Now imagine doing this in the grip of addiction to a drug that commands you to get your next dose fast.
This is not a criticism of the system. Many systems are hard to navigate, especially when they have a lot of parts that try to help a lot of people with different needs. The system is newly expanded as noted above, and is still expanding – and I’m grateful for all of that.
How it could work
Other systems have local government support to help users navigate. For example, the Capital Region’s Home Energy Navigator, which helps homeowners access provincial and federal grants for heat pumps. The same consideration could be shown to those on our streets, some of whom will have less capacity than homeowners to navigate complex systems. Obviously heat pump grants aren’t comparable to the detox-treatment-recovery pathway, but navigating either system is challenging, and challenging systems sometimes requires assistance.
A Detox-Treatment-Recovery System Access Navigator could proactively approach people on the streets to ask if they are ready to try to enter the system that day, and then provide help to access it.
This would not be a wide-ranging social worker or health-care worker, but rather a person whose only job is to reach out to people and help them contact appropriate offices.
There are of course outreach workers and social workers who do a wide range of things. I attend Downtown Service Providers every month and 900 Block Pandora group, and hear about them. They address many challenges facing the people on our streets, e.g.
- Getting people into shelters and housing
- Getting people basic medical treatment like wound care
- Taking people to appointments
- Getting people identification when they’ve lost theirs
- Reviving people who have overdosed
- Helping people pack up their tents and belongings in the morning
- Dealing with what have been termed “rapid response” or “unwanted person calls”
- Helping people get into compliance with bylaws
- Clean ups, and helping people get stuff into storage (of which more is needed)
- Bringing food to people who can’t get it on their own
- Bringing people clean sleeping bags.
- Etc…
These folks do heroic work – they are spread across a range of demands, typically overworked, and stretched to the limits.
What this motion proposes is a service that is focussed and targeted. Its aim is to help people who want to exit addiction to do so in a good way – through the detox-treatment-recovery pathway. This would likely be done by someone with lived experience, a peer who understands the challenges, and knows how to talk with people and when to leave them alone.
Some potential questions:
Is health care provincial jurisdiction?
Yes. However, the City of Victoria has been willing to pilot initiatives that could help to address the crises on our streets. We test things, and if they work, we try to get the province to adopt them, as noted in the Community Safety and Wellbeing Plan (s.2.2)
Is this a huge amount of work for City staff?
No, the vision is to hire a peer service to run this pilot.
Are there outreach and social workers who also try to get people into detox-treatment-recovery?
Yes, but are they also doing many other things, as noted earlier. This role would be sniper-focused as Councillor Coleman put it.
What about prevention?
We need that too.
Is this the solution to all the problems on the street?
No, and there isn’t one; there is no magic bullet. This is focussed on one thing. Another council initiative that was focussed was the Pandora Avenue Cleanliness Pilot Project motion. That motion, which arose from the Pandora 900 Block Group meetings I attend monthly, was dealing with waste, and helping people get involved and build their agency to make improvements on the street. We heard from staff on Thursday that the pilot is very successful.
Are there other things we need to be doing?
Definitely, and the City always does multiple things at once. All governments do so.
Does there need to be 2nd stage housing for people to get into after treatment?
Yes that’s part of the pathway, and it needs to be strengthened, like many other parts. (But even if parts of the pathway needs improvement I think we can all agree that we want people to get into the detox-treatment-recovery pathway.)
Is the city taking over medical assessment?
No, that’s not in any way a part of this proposal.
Is this “duplication and overlap”?
No, as noted above, the outreach workers and social workers on pandora are overworked and spread across a whole range of needs. The function of this role is focussed and targeted – similar to the Parks Relocation Coordinator service that the City adopted earlier this year. That service is focussed on getting people into existing housing, rather than performing a wide range of social and health support services. We didn’t hire that service to do a dozen things, but to do one – get people into housing. It doesn’t expand the supply of housing, but it gets the people to the front of the line. I hope to see Victoria people at the front of the line for BC’s detox-treatment-recovery pathway.
To sum up:
- We all want people to leave addiction via the detox-treatment-recovery pathway. We don’t want them leaving addiction by dying.
- That pathway exists in BC, and we want people in Victoria to be able to successfully access it when ready.
- This project could potentially help some people escape addiction, and escape the street.
As Mayor Alto says, in the future when we look back we will ask ourselves, and kids may ask us: did we try to do everything that we could?
I hope Council will try this.