The emergency department entrance to St. Paul's hospital in downtown Vancouver in March, 2020.JONATHAN HAYWARD/The Canadian Press
A new streamlined model of addictions care in the Vancouver area is shaving critical days off waiting lists and simplifying the intake process for people seeking help in its first months of operations.
Close to 100 people have benefited from the Road to Recovery program since it began rolling out operations in September, health officials said at an update on Monday. Architects of the model call it a “major transformation,” increasing treatment capacity largely by restructuring the existing system and creating a central point of intake.
It offers a glimmer of optimism during an enduring toxic drug crisis, though some say much more needs to be done in B.C.’s overall response to the evolving disaster.
First announced in March, Road to Recovery integrates what has long been a fragmented system of care that saw people calling around to various services, sometimes unsure of what they needed and often waiting on lists for weeks.
Co-founder Seonaid Nolan said people in the Metro Vancouver area can now call a single (Access Central) phone number, or present to St. Paul’s Hospital, and be assessed and placed by a health care team.
“Before, there were probably like 50 to 100 potential front doors, but you didn’t know what those front doors were or how to access them,” said Dr. Nolan, an addictions medicine physician, in an interview.
“With this new work with Access Central, we’ve been looking to create one front door where there’s one number that you call, or there’s one place that you go, and the wealth of resources – and comprehensive assessment to determine what resources you need – is all available to you if you enter through one of those two doors.”
Since September, 34 new beds have opened as part of the program, including 14 detox beds at St. Paul’s and 20 transitional care beds in the community, health officials said Monday. Ninety-four people have benefited so far.
When fully implemented in March, 2025, Road to Recovery is expected to comprise 25 acute stabilization and withdrawal management beds, 20 transitional stay beds at the hospital, and 50 recovery beds nearby in the community, run by Providence Health Care, the non-profit organization that operates St. Paul’s.
Co-founder Cheyenne Johnson, executive director of the BC Centre on Substance Use, said the BCCSU will also undertake a research and evaluation strategy to drive innovation and guide the program.
“Historically, if you look at clinical trials or more clinically-focused research, it really focuses on whether people are abstinent or not. And we know that people are much more complicated than just if they’re using substances or not,” she said.
Ms. Johnson said the program will undertake a health systems evaluation, looking at who is accessing beds and other services, give select people questionnaires and follow them through health administrative data – all as part of a five-year cohort study on general improvements in their lives.
Premier David Eby, who was part of Monday’s update, said there is potential to expand the model to a “couple” other sites in B.C. but provided no details.
Trey Helten, a manager at the Vancouver-based Overdose Prevention Society who regularly connects clients to services, says he has noticed improvements in the past month. Among half a dozen referrals, almost all received help within three or four days, down from what he says is a typical wait of two or more weeks. One person accessed detox in four hours, a speed he says he has not seen since the years before fentanyl supplanted the illicit drug supply.
Tyson Singh Kelsall, an outreach-based social worker in Vancouver’s Downtown Eastside and a PhD student in Simon Fraser University’s Faculty of Health Sciences, said Road to Recovery shows potential, noting its efforts to address the long-standing gaps between detox and treatment.
However, he said it would be “cruel” for government to label it as an integral part of its response to the toxic-drug crisis.
“What has been obvious on the street is becoming more and more clarified in emerging scientific research: Inpatient treatment puts people at risk of overdose and death if they are evicted or discharged, due to a lowered tolerance of the street supply, which regularly includes a mixture of ingredients,” Mr. Kelsall said.
“Stabilizing the drug supply is essential to reduce deaths and for treatment options to actually be effective. No number of beds can stabilize a volatile drug supply.”
He referenced a recent recommendation by a BC Coroners Service death review panel to expand the provision of pharmaceutical alternatives to illicit drugs outside of a prescription model.