Is Vancouver the mecca of drug treatment innovation?
'Getting better in Vancouver: Part 1': On the unregulated treatment industry in BC
Getting Better in Vancouver: Part 1 is a creative non-fiction story by WTH founding editor reijagrrl, originally published on her free newsletter, NOWHERE FAST,
It’s a gloomy February morning in 2021 as I wait for the intake coordinator at Onsite detox, one of three withdrawal management programs funded by Vancouver’s regional health authority.
After my orientation, I surrender my clothes/blankets/pillows/backpack to be washed and dried on high heat (a practice meant to kill bedbugs, cockroaches and other stowaways). They give me clothes to wear as I wait: cardboard slippers, a stiff rectangular top, a coffee-or-blood-stained waffle knit robe, and pajama pants so big I hold them up when I walk.
On day one, the uniformity of institutional “addictions care” renders us ageless, sexless, genderless; without futures or pasts; with no hobbies or favourite plants; without kids, (play)mates or pets.
After day one, many of us will wear combinations of our own clothes and those provided to us. For example, I pair a the waffle robe with my (comfy) cotton t-shirt and leggings (because robes have pockets, good for storing my phone and extra tea bags).
For those with minimal apparel (because they’re unhoused, or they’ve been robbed), detox-issue clothing is a must.
Operated by PHS Community Services Society, a non-governmental organization known for providing harm reduction-oriented services (like Insite), Onsite is the only Vancouver detox that provides each resident with a private room and washroom — a feature they call “detox with dignity.”
A large common area doubles as a dining room and activities space. Onsite hosts three or four activities each day, for those who can or want to participate. Activities include: art, yoga, meditation, acupuncture, drawing and reading.
There’s a flat-screen TV for watching local cable. And VHS tapes crowd the single bookcase, as if someone donated their beloved analogue video collection – Moonstruck, Fast Times, The Dead Zone, The Warriors. But the VCR player is broken.
Smoking cigarettes is allowed on a patio overlooking the back alley. We watch people buy drugs, get high, pass out, overdose. We listen to screams and sirens. We watch good Samaritans (usually other people who use drugs) give mouth-to-mouth, or Narcan, until paramedics arrive (ifthey arrive).
Onsite is also the only withdrawal management program in Vancouver that allows residents to smoke weed (for pain relief, and, I’m sure, scads of other reasons — most of which are unknown to me, because I don’t smoke pot).
Once settled, we are lovesick strangers, our minds and bodies at various stages of separation. I liken the (certain aspects of the) pain of withdrawal to what it’s like to break up with a lover I am crazy about — absolutely bananas. Maybe a Siamese twin, or a regular twin. The pain — it’s severity — will depend on the attachment. How heavy is the yolk? How sticky the connection? How tight is the bond between substance and receptor?
The word “detox” is actually a misnomer. Programs like Onsite are not actually designed to rid our bodies of all chemicals and toxins. While the idea is to rid us of street drugs, like opioid analogues, withdrawal management programs prescribe (controlled and regulated) opiate substitution meds — like methadone, still considered, by some doctors, to be the gold standard of opiate use disorder (OUD) treatment.
When locked up together — disarmed and defenceless — some of us make friends or acquaintances with another person who (ideally) shares some of our interests; someone who isn’t (at least, at first) obviously irritating.
This is natural, at least for me.
When I’m naked, raw and disconnected, I make wobbly bonds with one or two others. So I’m not alone. So I’ve got at least one other person to walk with, along the pathway through confusion, terror, and a type of grief stuck inside me like a shipwreck…
Stay tuned for the second instalment of Getting Better in Vancouver, written by WTH founder & contributor, reijagrrl.