BIG SHIFT IN WAY TO HELP ADDICTS HAS FRONT-LINE WORKERS OUTRAGED

Emphasis changing from detox beds to home aid for those in withdrawal

Drug addicts and alcoholics in Toronto have relied on a carefully balanced
network of detox beds and treatment programs to regain control of their
lives.

But changes to how those programs are delivered have outraged front-line
health workers, addicts and a city councillor, who called plans to close two
city detox centres shortsighted. (One centre has since been given a reprieve
because of community pressure.)

The new strategy shifts the emphasis from detox centres to "daytox" at-home
treatment sessions. One closed this week, cutting the number of detox beds
to 116 from 136.

The beds give addicts a clean place to stay as they battle withdrawal
symptoms, often for days, in a supervised environment. The provincial
Ministry of Health and Long-Term Care provides money for the program, which
is administered by St. Michael's Hospital, Saint Joseph's Health Centre, the
University Health Network and the Centre for Addiction and Mental Health.

Almost everyone agrees that the detox bed system has been misused by some
homeless individuals who are looking more for shelter than a place to get
free of a drug habit.

Those frequent visitors land in centres an average of twice a week, keeping
facilities too full to admit addicts with more serious problems, said
Michael Dean, manager of withdrawal services at St. Joseph's.

At least one Toronto centre turned away more than twice the number of people
it admitted, said a July report by Addictions Ontario, a non-profit
organization dealing with drug and alcohol addiction.

"We're bringing these people in, and we're monitoring them every 15-30
minutes . . . but very few of the people who come to our centres are in
severe withdrawal," Mr. Dean said.

The Health Ministry agreed to a request made by the hospitals in July that
would have closed both detox centres in Toronto's downtown core and diverted
the $1.4-million in funding to new day programs.

Health centres would hire assessment workers to visit addicts at home and,
over the course of a few hours, determine whether the person needed a bed or
a different treatment option.

Some of the money will be used to create a 24-hour central detox number,
eliminating the need for addicts to try finding a bed at the five remaining
detox centres. Other workers will run day-only counselling services.

The new system will be more "efficient," "comprehensive" and serve an
additional 1,500 addicts a year, said David Spencer, a spokesman for the
Health Ministry.

Peter Selby, clinical addictions director at the Centre for Addiction and
Mental Health, called it a "radical" shift in the way Toronto handles
addiction treatment.

"Yes, it was radical, but I think it was much needed," he said. "Some
decisions are painful, but I think overall the system will be much better
off for it and the clients will be better off for it."

But front-line health workers who administer the program remain unconvinced
and said they are angry that they were not consulted.

A group calling itself the Coalition Against Detox Closures held a
boisterous and noisy rally this week to protest against the closing of the
20-bed detox facility at 501 Queen St. W.

City Councillor Jane Pitfield complained that the city wasn't consulted,
called the plan "shameful," and said "it could mean the population of
addicted people will grow" on the streets.

Addiction counsellor Joel Richmond said: "The people that are hurt are the
people who have nothing. It is a shame."

Despite the protest, the Centre for Addiction and Mental Health closed the
Queen Street site on Wednesday. A second 22-bed detox centre at Ossington
Avenue near Queen Street, was scheduled to close at the end of October, but
the provincial government granted it a reprieve until next year in the face
of community pressure.

In the meantime, six new detox beds will be created at St. Joseph's this
month.