Detox wait times plummet after B.C. innovates drug treatment intake

Treatment for drug and alcohol addiction is a challenging process, with detox alone proving too difficult for some.

A single phone number opens the door to a range of treatments for people looking to overcome drug and alcohol addiction in Vancouver Coastal Health communities, and that system has seen wait times plunge for detox beds.

The Road to Recovery (R2R) program rolled out at St. Paul’s Hospital two years ago and has proven so successful, the “one stop shop” model is being rolled out across the province, as administrators apply the efficiency and prioritization principles to recovery beds as well.

“The previous addiction treatment system was fairly fragmented, and it was really difficult for patients and their families to navigate,” said R2R co-founder and addiction physician, Dr. Seonaid Nolan.

“Through the creation of a single front door, it streamlines people to one single telephone number to call to access substance use services.”

Callers are triaged by a nurse or doctor who assesses their needs and assigns them to the next available detox bed within the health authority. Those at highest risk from their withdrawal symptoms – which can range from hallucinations to complications that can land a patient in the intensive care unit – are treated at St. Paul’s Hospital.

While the wait for recovery beds has gone from months to weeks, some patients are now able to go into detox that same day, so Nolan is frustrated at the political rhetoric claiming treatment is unavailable and that government isn’t focused on recovery from addiction.

“It is incredibly frustrating, and it’s actually harmful,” she said. “It’s harmful to patients when they hear bits of information that is inaccurate or false and deters them from accessing services that may otherwise meet their needs.”

Patients who can’t get into detox within a day or two may be prescribed an opioid substitute, like methadone or Suboxone that day, and peer-led support and group programs are ready to take newcomers on short notice.

Jamie’s story

Jamie Ramsey has first-hand experience with the streamlined system after reaching a precarious level of alcohol use. After struggling with alcohol since her teens, late last year she began binge-drinking for days at a time and going to the emergency department with intense withdrawal twice.

“I definitely felt super overwhelmed, super embarrassed that I was there for something like that,” she said, describing feeling like the ER doctors didn’t know how to handle her situation.

The second time, she was hospitalized by ambulance, and the paramedics suggested they take her to the Rapid Access Addiction Care Clinic so she could access the Road to Recovery intake.

The 25 year-old was relieved that after explaining her situation once, she didn’t have to keep repeating herself when encountering a new health-care provider. She said the doctors, nurses, and support workers were warm and understanding about her addiction and her precarious living situation. She went into detox the next day and is now thriving in recovery.

“All I had to do was show up and say, ‘I need help,’ and everything else that I needed to be done was guided for me,” Ramsey said. “It’s helpful being able to go to someone and say, ‘What do you think is the best thing for me, because I don’t know if I can make these choices for myself?’”

Treatment is fraught

While the government is bringing online more detox and treatment beds for alcohol and illicit drug users, progress is slow and the NDP faces fresh waves of criticism each time a stranger attack or surge in street disorder makes headlines.

Experts caution that treatment itself isn’t a one-size-fits-all situation.

“One thing that people don’t understand about addiction treatment is how incomplete our knowledge is of how to cure people,” said Dr. Mark Lysyshyn, deputy chief medical health officer for Vancouver Coastal health.

“Even our best, most evidence-based treatment for addiction doesn’t work for half of people.”

Privately run detox facilities and drug treatment centres offer a variety of alternative approaches, from religious- to agricultural-based programs, but the industry is not regulated and it’s unclear how effective they are for patients. Given that some charge five-figure monthly fees, the industry has faced calls for a probe.

No one in the R2R program at St. Paul’s Hospital is compelled to be there, and they can leave at any time.

“This is a purely voluntary system of care,” Nolan explained. “We recognize that experiencing withdrawal for many different reasons can be an intense emotional, physical, spiritual journey.”

This is the fourth installment in a five-part series exploring British Columbia’s response to addiction and toxic drugs, as well as factors contributing to the crisis.

Read part 1 here: How B.C.’s approach to toxic drugs and addiction is changing

Read part 2 here: Deaths of despair: Gabor Maté urges empathy during B.C.’s toxic drug crisis

Read part 3 here: From shame and secrecy to Suboxone: B.C. drug users credit harm reduction for recoveries

Read part 5 here: Normalizing relapse and supportive housing: B.C.’s drug recovery spectrum evolves