HARM-REDUCTION APPROACH EFFECTIVE AT SEATON HOUSE

An Innovative Program Keeps Drunks Out Of Emergency Ward, Joe Fiorito
Discovers At Hostel

The men who stand in the corridor are restless, nervous, full of jokes and
jibes, or else they are sullen and won't look you in the eye. Some have the
shakes. Others look as if they want to weep.

They live at Seaton House; they are drunks, lining up for plastic cups of
wine. They brew it themselves and call it pony piss because it's yellow, it
doesn't taste good and it has a kick.

The wine costs the city $50,000 a year, a third of which is recovered from
the men at the rate of half a buck a cup. The wine is not good, but it is
cheap at twice the price.

If it were not on offer in this shelter, these men would be heading to
emergency in ambulances. They'd be stoned on mouthwash, rubbing alcohol,
vanilla, glue or aerosol -- whatever it takes to get high. They'd be dying
on the street.

Some have been through 100 nights of detox. Some are mentally ill. Some
have failed at everything. None of them can cope. They are willing to go as
low as they can to get as high as they can. There is no conventional way to
stop them. But if a cup of pony piss is what it takes to lure a man off the
street and wean him from Lysol . . .

That's the principle of harm reduction at Seaton House. It's simple
pragmatism. You offer the lesser evil; along the way, you provide care and
counselling.

The first pour is at 8:30 a.m. The last at midnight. Some men take a drink
an hour. Most drink every 90 minutes. A guy could get 16 drinks a day.
Nobody drinks the max.

The wicket opens, a young staffer pours and the line moves forward quickly.
There is no lingering. Hands tremble, guys close their eyes and it's down
the hatch. There is some spillage; the floor is mopped before it gets too
sticky.

Art Manuel runs the harm reduction program. He spots Garry coming down the
hall. Garry's hair is lank; his eyes are wet; he's got the shakes, and he's
too late for the line. He tells Art that he hurts. He pleads, and hates
himself for pleading. Art breaks a rule and pours him a drink. What of it?

A few years ago, there were no wet shelters in Toronto. If a drunk showed
up with a bottle, he was turned away. So guys would guzzle what they had;
sometimes they'd get unruly, and then they'd be turned out onto the street.
It took the deaths of three alkies one winter, and a coroner's report . . .

Before long, Art was not just storing bottles for guys at Seaton House; he
was doling out drinks from the bottles. Then he was buying booze and doling
that out, too, because there were too many guys like Garry, whose idea of a
good time was "a pack of smokes and two magnums of brown Listerine."

Art reasoned that if he could keep a man in Seaton House, he could help him
work on his problems.

Cheaper than an ambulance, better than the morgue.

The city didn't know Art was buying booze at first; he disguised the
expense in his budget as mineral water. There was a sign at Seaton House:
"No mineral water before 8:00 a.m."

It couldn't last forever. The cheapest booze at the LCBO was too expensive.
After a couple of months, Art figured he could save money by getting the
men to brew their booze themselves.

Simple. Pragmatic. Brilliant.

Nearly 500 guys have been through the program since November, 1996. Some
have cleaned up completely. Some have moved on to nursing homes. Some have
died; they'd have died anyway. Along the way, they've all had access to
things they did not have on the street: doctors, nurses, counsellors.

Garry levels off after his cup. One of the staff asks him if he wants to
make a batch of wine. Garry used to have a responsible job, a wife and
kids, a swank house in Oshawa; now he's got nothing except this bit of
responsibility. He nods his head.

Off they go to Scarborough. And in a brew-it-yourself joint in an
industrial mall, Garry sprinkles yeast into buckets of water-diluted grape
concentrate; after it ferments, it will be poured into a carboy, then
racked off into stiff-sided plastic bags. The men of Seaton House drink 900
litres of this stuff a month. The vintage is not rare or expensive.

It is merely precious.