Pubdate: Mon, 25 Aug 2008 Source: Globe and Mail (Canada) Copyright: 2008 The Globe and Mail Company Contact: http://www.globeandmail.ca/ Details: http://www.mapinc.org/media/168 Author: Anna Mehler Paperny DETOX CENTRE ABOVE INSITE CANNOT MEET DEMAND VANCOUVER -- Onsite, the detox and recovery facility a floor above Vancouver's controversial supervised-injection site, is approaching its first anniversary operating at full capacity: Its beds are full, it has a 30-person waiting list and the facility's proponents point to it as evidence that Insite succeeds in helping the city's most desperate addicts get off the street and into treatment. But only a small fraction of the people who enter Onsite's detox and stabilization facilities complete their treatment programs, and addiction doctors say the beds Onsite provides don't begin to put a dent in the enormous need for more addiction-recovery facilities across British Columbia. Since Onsite opened in September, 2007, its detox centre has had 343 visits, 157 people graduated to its longer-term stabilization facility, and 46 of them made it at least one month drug-free. Supervisor Russell Maynard said he personally knows nine people who have been through Onsite and have been clean for several months. In that year-long period, more than 2,000 injecting drug users have made use of Insite's sterilized syringes, drug paraphernalia and nurse supervision. Insite gets 800 visits a day, some from repeat users who will come as many as 10 times daily to shoot up. The supervised-injection site recently celebrated its millionth visit since it opened in 2003. Insite connects addicts with treatment they would not otherwise get, said Mark Townsend, a spokesman for the Portland Hotel Society which runs Insite and Onsite along with the Vancouver Coastal Health Authority. "When you think of an addict in an alley versus an addict injecting with a nurse, there's more human contact," he said. "You build a relationship with someone and they say, 'I'm feeling rough,' and you say, 'Would you like to go to detox?' " Onsite didn't get started until four years into Insite's supervised-injection site program. Mr. Maynard said it took seven years to get the funding and approval to open the upstairs detox centre, but all its beds have been full since January and the facility has a 30-person waiting list. "We can't keep up with the demand," he said. Onsite patients stay longer, on average, than patients at Vancouver Coastal Health's other detox centres, a fact that Mr. Maynard chalks up to the community that Insite and Onsite offer addicts, and the effort the facilities make to give clients more dignity: Addicts in withdrawal get their own rooms with adjoining bathrooms, he said. "If you've got the runs or the chills, you can stand under the water or hug the toilet, whatever the case may be. You have a lot less excuses to say, 'I'm out of here.' " But Onsite's completion rates are low: Just over half of the people who enter detox stay until the drugs are out of their system, and less than a third of people in the stabilization program make it a month drug-free. The average detox or stabilization facility sees the vast majority of patients at least complete the initial program, said Alan Campbell, Vancouver Island Health Authority's mental health and addiction services director. He said Onsite's attrition rates could be due to its gritty demographic. "They are in a very hard-core area ... so they may be attracting people who have very entrenched, addicted lifestyles." New Westminster addiction doctor Donald Hedges, who has been a vocal critic of Insite, said its detox beds are insignificant in the face of a massive, provincewide shortage: Both Vancouver and Victoria have long waiting lists for their beds, and it's unlikely the neediest addicts will wait long for treatment. "What they need is immediate, unlimited access to treatment on demand," he said. "We're not coming close to funding necessary detox and treatment for this disease." - --- MAP posted-by: Keith Brilhart