Pubdate: Sat, 18 Jul 2015
Source: Globe and Mail (Canada)
Copyright: 2015 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Wendy Stueck
Page: S1

NO GUARANTEED OUTCOMES FOR ADDICTS SEEKING HELP

The system of support recovery homes in Surrey is fragmented, poorly
funded and lacks regulatory oversight, Wendy Stueck reports

Galven Young is a self-described reformed addict who has spent time in
several recovery houses in the Lower Mainland.

Now employed as a support worker at an abstinence-based recovery
centre in Chilliwack, B.C., Mr. Young says he has seen many such
facilities, from provincially registered ones that provide structured
programs and healthy meals to unregistered homes in which illicit drug
use is routine and food in short supply.

But until you are in the door, it is difficult to know what to expect,
he says.

"The clients are people who may be looking at going to jail and so
they pull the recovery card. They say, 'I'm going to go into treatment
and do better,' " Mr. Young says.

That outcome is not guaranteed - in part, critics maintain, because
the system in B.C. is fragmented, poorly funded and lacks regulatory
oversight.

Support recovery homes are small residential facilities with fewer
than a dozen beds that provide housing and treatment for people with
addictions.

An April report on support recovery homes by the Community Action
Initiative, a provincial agency that funds mental-health and
substance-use programs, found concerns exist about whether the
facilities are registered or not.

The agency also found "clients and families lack sufficient knowledge
about what a registered support recovery home should offer. For
example, a complaints process, fire safety measures, psychosocial
programming, etc."

"Unfortunately, the current system of regulation through the [assisted
living registry] and per diem funding through the ministry of social
development is not creating a province-wide recovery house system that
individuals, families, communities, and health, social service and
justice system referral agencies can trust," Mr. Lamontagne said in a
letter dated May 25.

Such concerns date back more than a decade. Between 1998 and 2001, the
province required recovery homes to be licensed. That requirement was
lifted in 2001 to reduce red tape and operating costs.

That resulted in a flurry of new homes and complaints that some
offered a roof and little else.

In 2013, the province introduced a program that allowed recovery
houses to register through the ALR.

Operators that register commit to provide certain services, and become
eligible for provincial funding of $30.90 a day for each client who is
on social assistance, from whom they also usually collect $550 a month.

Currently, 98 recovery homes are registered, and 31 registrations are
in process.

Under the new regime, recovery homes must register if they offer at
least one "personal assistance" service, such as courses in anger or
stress management, and five "hospitality" services, including meals
and a 24-hour emergency response system.

"Houses that do not offer this level of service - regardless of what
they call themselves - are not supportive recovery homes," Ministry of
Health spokeswoman Cindy MacDougall said in an e-mail. "These
[unregulated] homes are bound by municipal and criminal laws."

Mike Starchuk, a Surrey city councillor who is a former chief fire
prevention officer in the city, campaigned last year on the issue of
unregulated recovery homes.

He supports the provincial registry, but wants to see more, including
requirements for recovery homes to obtain a city business licence, and
more resources for spot inspections.

Under the current system, he says, some operators are doing the
paperwork to obtain registration and meet requirements but are not
necessarily following through with programming and services.

"It gives the city a tool," he said. Currently, he said, some
unscrupulous operators can invest enough money to ensure their
buildings meet fire safety requirements and can pass an initial
inspection, but then operate a home in which residents are allowed to
continue using or even selling drugs while the owner collects the
government money.

Mr. Starchuk would like to see more resources devoted to inspections
to stop such abuse.

"They [the registry] really need some bodies and some help to do what
they are supposed to do," Mr. Starchuk says.

In spite of all the problems, many people say they had good
experiences in recovery homes.

Mr. Young said he benefited from his treatment at Vision Quest, as do
many others.

"For me, this place has saved my life," he said. "And I know I'm not
the only person here who would say that."

In that report, the agency included several ideas for boosting
capacity in the sector, including public education on the standards
and guidelines of the province's Assisted Living Registry, which
regulates residences such as the recovery houses and seniors' homes.

In Surrey, which has grappled with problems related to scores of
unregulated recovery homes, planning manager Jean Lamontagne
recommended that council support further study by the CAI to develop
comprehensive provincial framework for the facilities.

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Low-threshold Alternative

The ongoing debate about recovery homes in B.C. is part of the
broader, complex challenge of tackling mental health and
substance-abuse issues in the province, where an estimated one in five
people deal with such problems each year.

One new strategy could involve a low-threshold or low-barrier
methadone clinic - which gets its name because it would reduce or
eliminate some hurdles patients currently face obtaining the drug as a
substitute for heroin.

A low-threshold methadone clinic is among more than 20 initiatives
outlined in a February paper from the Downtown Eastside Second
Generation Health System Strategy. This evolving plan by Vancouver
Coastal Health would streamline health services in the neighbourhood,
which has about 18,000 residents and more than 20 VCH-affiliated
agencies and clinics in a six-block radius.

In a low-barrier approach, methadone clients would be expected to cut
back their use of heroin but not necessarily eliminate it - based on a
rationale that fewer injections would help reduce the risk of
blood-borne diseases, infections and other health concerns. In
conventional methadone maintenance treatment, patients are expected to
stop using heroin and stick to a set dosage of methadone.

The idea would be to give people who want methadone treatment what is
now on offer for injection drug users at Insite - a one-stop shop
where patients could get access to methadone as well as medical care
and counselling.

"Essentially, what we would be trying to do is emulate the =C2=85 process

we have at Insite and to engage those clients into treatment," said
Ron Joe, associate medical director of addiction services with
Vancouver Coastal Health.

Methadone is one of the most effective medications to treat opioid
addiction, and drug-use statistics suggest there are many more
Canadians who could benefit from it beyond those already receiving it,
Dr. Joe says.

According to the 2012 Canadian Alcohol and Drug Use Monitoring Survey,
0.5 per cent of Canadians and 0.8 per cent of British Columbians
reported using heroin in their lifetime. (Those estimates were flagged
with an "interpret with caution" note, as they were based on a small
number of respondents).

But even if those estimates are too high, they still suggest thousands
of people in B.C. and Canada need methadone treatment, he says.

"We have perhaps treated the easier half of the population, and the
harder half, the more difficult half, are the ones who are still going
to Insite or maybe not going to Insite - and we haven't cracked that
nut of engaging those people into treatment," Dr. Joe said.

"So we need a specialized service to do that and that's where the
low-barrier methadone site would come in."
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MAP posted-by: Matt