'ALWAYS MORE DEMAND THAN RESOURCE'

An drug addict or alcoholic in Victoria who wants help can usually
get a place in medically assisted detox within about a week.

While access to the Community Medical Detox Unit in the Eric Martin
Pavilion often requires a referral from a family doctor or a social
agency, clients can initiate contact on their own.

The facility has 21 beds where addicts and alcoholics can spend up to
10 days of medically supervised withdrawal treatment. A doctor may
prescribe anti-seizure medications for detoxing alcoholics or
antidiarrhea medication frequently required by heroin or opiate abusers.

The 21-unit detox centre discharges patients after an average of
seven days. That means 84 patients per month need the next stage, a a
longer-term stabilization program, but there's not enough space.

The Pembroke Place Stabilization Unit, near Cook and Pembroke
Streets, offers help getting through what health-care providers call
the "post acute withdrawal syndrome" stage.

But Pembroke has only 17 beds, and stays there last about a month.

"Do the math," says Bob McKechnie, manager for addictions for the
Vancouver Island Health Authority. "The 17 beds is clearly a bottleneck."

Pembroke has a safe, secure monitored environment with three meals a
day. Newly detoxed patients might be clean and sober, but are often
weak and confused. And it can be inadvisable for them to return to a
previous home or neighbourhood.

Pembroke has a nurse 12 hours a day, seven days a week, who
administers prescribed medications. Addictions workers are on site
around the clock and a psychiatrist is available part-time.

Pembroke's patients are gradually reintroduced to the community,
going out in the daytime to obtain income assistance or job
counselling and to try to find a family doctor.

Following stabilization and several weeks of living clean, addicts
can apply to one of the region's three supportive recovery
facilities. They can stay for up to three months, but don't get
on-site treatment.

The facilities operate like group homes, with clients cooking their
meals and living co-operatively. Supervision is provided by an
addictions worker in the day, and at night a senior patient or client
is usually in charge.

Lilac Place and Holly Place are five-bed supportive recovery
facilities for women; the Grove is a 10-bed facility for men.

McKechnie says the initial stabilization following detox often sees
addicts reconnected with family or put into housing of their own.

All counselling, psychiatric assessment and treatment is done through
Addictions Outpatient Support, where there can be waits of up to a
month to see a counsellor.

Last year, counselling service was reduced to 12 full-time staff from
15 in an effort to shift resources to northern Vancouver Island,
where the waits were longer.

McKechnie agrees the service could be better -but these days, every
health-care service is pressed.

And he says that while bottlenecks are obvious, there has been an
enormous boost over the past few years for addiction treatment.
Supportive recovery and stablization has doubled in the past three
years. Detox services have tripled. And while addiction outpatient
counselling was reduced in Victoria, service was badly needed on the
north Island.

"The taxpayers pay what they can, then it's our job as public
servants to make the maximum best use of the resources," he says.

"Probably in none of our services, maybe with the exception of detox,
is there enough capacity," said McKechnie. "That's just the way
health care is. There is always more demand than there is resource."

Publicly funded services in Victoria:

- - Sobering Assessment Centre, 1125 Pembroke St., has 20 beds
providing shelter and assessment of inebriated people. Police,
hospital emergency rooms often refer clients and walk-ins are accepted.

- - Community Medical Detox Unit, Eric Martin Pavilion, has 21 beds
offering stays up to 10 days for an addicted client to undergo
medically supervised withdrawal during the most acute symptoms.
Access, normally available within 10 days, is usually achieved
through a referral from a doctor or community agency. Clients can
also contact Withdrawal Management Services Intake at 250-213-4441.

- - Withdrawal Management Services Intake, 250-213-4441, 1125 Pembroke,
8: 30 a.m. to 9 p.m., operates by referral from a physician or
agency, or clients can make contact on their own. The most urgent
cases are admitted first.

- - Pembroke Place Stabilization Unit, 1125 Pembroke St. is a 17-bed
unit offering stays up to 30 days for addicted patients, once clear
of detox or withdrawals. Patients can receive counselling on an
outpatient basis and get reconnected with the community, and groups
such as Alcoholics Anonymous or Narcotics Anonymous.

- - Addictions Outpatient Support, 1250 Quadra St., provides a flexible
day program for clients new to recovery. Counselling, group therapy
and referrals to other agencies are available. Referrals from
doctors, community groups are necessary. Clients looking for help
there should contact Withdrawal Management Services Intake,
250-213-4441, for a referral. All referrals are triaged daily.

- - Supportive Recovery Facilities provides a safe environment, with
minimal supervision, for up to three months for addicts to continue
with recovery and solidify earlier success: Lilac Place, five beds
for women only, Holly Place, five beds for women only, The Grove, 10
beds, three months, men only.