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Health Authority estimates 5,000 people on the Downtown Eastside need treatment
By Hempology | January 14, 2008
Vancouver Sun, BC
12 Jan 2008
Daphne Bramham
A NEVER-ENDING TALE OF POLITICAL NEGLECT
Principals Of All Three Levels Of Government Have Pretended For Decades That One Stop-Gap Measure Is A Solution
A decade and several elections ago, the three levels of government and their many and varied agencies agreed that an integrated approach was the only way to heal the problems of Vancouver’s Downtown Eastside.
That was the genesis of the Four Pillars plan and the controversial decisions to provide free needles, supervised injection sites and, later this year, free mouthpieces for cocaine pipes.
In their search for solutions, politicians rather neatly neglected to acknowledge their responsibility for the perfect storm that has devastated the neighbourhood and left hundreds, if not thousands, of people dead.
Ottawa stopped funding low-income housing in the 1990s. Today, there’s a housing crisis across Metro Vancouver, the most expensive urban area in Canada.
To make up for the lack of affordable housing, the B.C. government changed its rules so that welfare recipients could live in single-room occupancy hotels. That concentrated the poor in older hotels all within a very small area near the Carnegie Centre at Main and Hastings streets.
All of that coincided with closures of mental hospitals. But the provincial government failed to provide the promised alternative housing, the group homes and supervised living arrangements on which the success of de-institutionalization depended. The number of beds for people with mental health problems plummeted from 5,000 to 800.
The B.C. government closed Pender Detox, the largest residential detox program for people with alcohol and drug addictions. Other social service agencies closed in the name of deficit-fighting.
A decade later, we’re still trying to make up for what was lost since 1998. And all of that would have been bad enough — a shortage of affordable housing, lack of jobs and the ready supply of drugs and alcohol — without HIV/AIDS. Combined, those factors resulted in an AIDS epidemic on a scale seen only in Africa, not in any other developed or developing countries of the world. By 1998, 40 per cent of the injection drug users were infected with HIV.
Syphilis and tuberculosis were also at epidemic proportions even as Vancouver began being recognized as one of the world’s most livable cities ( unless you’re poor, addicted or mentally ill. )
The folly of governments’ containment strategy — ghettoizing the poor, the addicted, the sick and the mentally ill in cheap rooms downtown — spilled out on to the streets and alleys that quickly turned into filthy, garbage-strewn shooting galleries, open drug markets and home to a growing survival sex trade whose workers started disappearing and nobody seemed to care.
Because of the crisis, local, provincial and federal politicians embraced the harm-reduction strategy as a stop-gap measure to keep people alive until housing, detox, treatment and recovery programs were in place. But the politicians have so heartily embraced the harm-reduction model, it’s virtually all that they talk about or fund.
There’s something politically appealing about being a maverick opening North America’s first supervised injection site or promising free heroin. It gets you on magazine covers, in documentaries. It gets you invitations to international conferences.
Most of all, it beats the hell out of sitting through long public hearings with angry residents who don’t want addiction treatment facilities in their neighbourhood whether it’s on Hastings, Fraser, Dunbar or Fir Street. That’s especially true if, in the end, the decision is to ignore the opposition and approve it anyway, because it’s the right thing to do and the only thing that makes a stab at solving the horrific addiction problems in this city, region and province.
And that’s where we find ourselves a decade on. The dramatic stuff, the headline stuff, the harm-reduction pillar has mostly been done. The epidemics have subsided. Fewer addicts overdose on the streets. There’s been a reduction in other infectious diseases that require hospital stays.
All this harm reduction has kept people alive. The question is, for what? Are there decent places for them to live as they recover? Are there services available for what is a long road to recovery because everyone from addictions specialists to the Vancouver Coastal Health Authority agrees that recovery means leading a substance-free life, not swapping heroin for methadone, cocaine for marijuana or Ativan for some other pharmaceutical?
The short answer is no. But there’s good news on the housing front largely because of the B.C. government and Housing Minister Rich Coleman. Politicians will have plenty sod-turnings and ribbon-cuttings to attend over the next five years because there are 3,200 units of social housing on the drawing board for Vancouver.
It’s a level of production that hasn’t existed since the 1990s. Among the projects are redevelopment of Woodward’s, the provincial government’s renovations of 10 single-room occupancy hotels in the Downtown Eastside and redevelopment of public housing sites, including one in Little Mountain.
It’s the treatment pillar that lacks a champion. Coleman has talked about treatment supports being included in some of the new housing units. But so far, there’s no commitment of funds.
Over the past decade, Vancouver Coastal has improved access to detox and rehabilitation facilities with little or no fanfare. It is the first city in Canada to have four levels of detox care. But when it started Canada’s only fully supported, home detox program, there weren’t any politicians trumpeting it to journalists.
Vancouver Coastal Health Authority estimates 5,000 people on the Downtown Eastside need treatment for addictions and mental health problems. Close to half of them need significant amounts of help and somewhere between 250 and 500 need significant and long-term addictions treatment in a residential facility.
To provide that kind of support, Vancouver Coastal recommends that, at a minimum, Vancouver needs a 30- to 60-bed facility to deal with those in the greatest need. There needs to be a shorter-term stabilization facility for 30 to 60 of those who need significant support on the road to recovery.
And that’s just for the Downtown Eastside. It doesn’t take into account the addicts living in other neighbourhoods or cities. Or kids. Operating money has been promised for the residential youth recovery centre that’s planned for Keremeos. But, so far, there’s not enough money to build it.
There’s a civic election in November, a federal election that could come along any day and a provincial election in the spring of 2009.
It’s not enough for the politicians to acknowledge the problems of addiction and homelessness. It’s not enough for them to keep piling on more harm-reduction programs.
We need solutions. We need strong leaders willing to stand up to the Not-in-Anybody’s-Backyarders and fight not just to keep people alive, but to help them make a full recovery.
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