'Good things happen when you're clean': More detox beds needed
London has 18 detox beds and wait times for treatment can be weeks
In a city facing a drug crisis that officials are calling a public health emergency, there are only 18 detox beds and the wait time to access one can be weeks.
"There can be nothing more discouraging than going to the withdrawal management centre and being turned away," said Dr. Martyn Judson, an addictions specialist with Clinic 528 who has been treating people with drug dependency for decades.
"People who enter recovery do so when they're ready. The important thing is to be available when they're ready. They have to have someone they can talk to, they can trust, they can rely on, and someone who will listen."
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London's detox beds are just a small part of treatment options that should be available for people who use drugs and want to cut down or stop, say those who work with drug users.
"There's quite a variety of options but the continuum is not as developed as it should be," said Nancy Powers, the executive director of the Salvation Army Centre of Hope, which operates London's only overnight detox centre.
How to get a bed
The withdrawal management program includes beds for men and women. There are no doctors or nurses there, though there are qualified people who supervise the withdrawal. Sometimes people are sent to the emergency room if their withdrawal symptoms escalate.
The program is often full, but staff there have started a new protocol, calling those who have had to be turned away.
"We've changed our process because we don't want people to lose a bed if they can't get in right away. They get called back when there's a bed available," Powers said.
"You want to capture people when they're ready. When you're ready to enter recovery, it's a now thing, it's not in three days."
People stay at the detox centre for a few days and then get referred to further treatment options, often through Addiction Services of Thames Valley.
Waits for that treatment can be weeks, Powers said.
Tom's story
Tom started smoking crack when he was 19 years old.
In his hometown of Scarborough, he couldn't walk a block without running into someone with whom he'd used drugs, he told CBC News.
In late July, he packed a backpack, left his apartment and hopped on a bus to London.
"I didn't know anyone here. I can't be around people who use," the 39-year-old said. "I went to the Salvation Army Centre of Hope detox.
"[It's] a good place to go to get started. The people there help you, they want to see you do better, and they'll give you everything they can do help you."
Tom spent seven days in a withdrawal management bed, and has been sober for 81 days.
He hopes to stay clean on his own.
"It's a better way to live. Good things happen when you're clean."
Post-detox services critical
After leaving the withdrawal management centre, people can either try to stay sober on their own, or get a variety of treatments.
"Harm reduction and treatment are not exclusive of one another, it's not an either or. It's a continuum," said Linda Sibley, the executive director of Addiction Services of Thames Valley. "They have access to a menu of options. It varies from person to person."
Addiction Services also employs nurses and nurse practitioners who can help people withdraw from substances in their own homes, Sibley said.
"Medical detox was always though of as a bed and supervision by a nurse, who is supervised by a physician, who is trained in the medical aspects of addiction," Sibley said. "We've moved away from that because most people don't require that. Along the way we've developed community based medical withdrawal management."
Only 10 per cent of people go to residential treatment, at a facility in Elliott Lake, she said.
The problem with releasing people back into community, Judson said, is that they revert back to old patterns.
"It's a revolving door phenomenon. Where do people go after they've stopped using? They can't go home because they probably live in a drug den, on the street. What's needed are halfway houses, hostels, places that can provide a fairly structured existence."
Often, people don't know what services are available, said Sibley.
"Equally professional treatment can successfully happen in an outpatient setting," she said. "There's a huge misunderstanding of what treatment is."
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