DTES alcohol-replacement program in jeopardy
Outside the PHS managed alcohol program’s lounge in Vancouver, a passed out woman lies on a patch of grass while others nearby keep an eye on her to make sure the situation doesn’t deteriorate.
Inside, another woman hurls obscenities and accusations at a man while members continue sanitizing bottles and stirring homemade wine as though they’ve heard it all before.
There are days when fights break out and when people are asked to go cool off elsewhere, but the little program on Princess Avenue beats the other options that usually include jail, the emergency room or, in recent years, fentanyl poisoning, according to those who run and use it.
Tyler Bigchild, 38, was part of a small group of drinkers involved in the program’s earliest days, before it became official in 2013. Back then, they called it the Drinker’s Lounge and it was part of Portland Hotel Society’s defunct Drug Users Resource Centre.
“My alcohol use was hardcore, I’d be drinking anything I could,” said Bigchild, listing rubbing alcohol, mouthwash, gel hand sanitizer and bottles he stole from liquor stores.
With the program, Bigchild now has regular access to homemade wine and beer that is safe and clean, and a place full of friends to visit every day, he said. He keeps himself busy by brewing and by bringing bottles of water out to the community.
Police walk past him on the street and he has reconnected with family back east. He’s still a drinker but the program’s members have become like family, too, he said. “It’s unfortunate that it’s like this,” he said. “But this is the only community centre that we really have down here in the Downtown Eastside.”
Also unfortunate is that the $150,000 program’s threadbare funding is now falling short and its future is in jeopardy, according to Dr. Alana Hirsh, a PHS physician who runs a weekly medical clinic in the lounge, and program coordinator Michelle Wishart. Hirsh said there is no funding planned for 2019, only donations made to PHS to specifically keep it going. Meantime, in a city battling fentanyl and housing crises, non-profits find their resources stretched thin. They’re hoping to double the funding so that they can expand.
The program serves more than 100 people each week, including 40 who come in daily, as well as an extended community that drops in occasionally to buy and exchange alcohol.
Wishart said many of those who use the program have been barred from other drop-in centres, shelters and services. The lounge brings them in from the street.
“As long as you’re a drinker, you’re welcome,” Wishart said.
Members buy a brew kit for $40 or $50 and are paid a small stipend to make beer and wine, which sells for $2 and $2.50 per litre, respectively. They can also exchange non-beverage alcohol for the safer homebrew. They are connected to PHS’s other services, including physicians, counsellors and housing.
“We get to build really special relationships with folks that other people maybe don’t have an opportunity to,” Wishart said. “They come in here and you can be drunk, you can be drinking, and that doesn’t prevent you from accessing these services.”
Most members’ alcohol-use disorder is severe. About half of the core group is homeless. Many have liver disease, are poly-substance users and suffer from malnutrition. About two-thirds are men, most of them 25 to 55 years old, and most are Indigenous.
B.C. is the top province for alcohol-related hospitalizations, with nearly 15,000 admissions in 2015-2016, according to a report by the Canadian Institute for Health Information.
That report also found that provinces spend $8,100 every time someone is hospitalized because of heavy drinking, compared to the $5,800 spent on most other hospital stays. Across Canada, hospitalizations caused by alcohol (77,000) exceeded those caused by heart attacks (75,000), according to the Canadian Centre on Substance Use and Addiction.
Joseph Rufus, an advocate with Culture Saves Lives, joined the program last year. His group also regularly visits to smudge, drum and hold ceremonies. The drinkers are respectful and calm down when they turn up, he said.
“When it comes to singing in our language, as soon as you hear that, it doesn’t matter what state you’re in,” he said. “Immediately, you’re paying attention.”
Lately, a lot of the ceremonies involve remembering the dead.
“A lot of the times, they’re our brothers and sisters who do suffer from alcoholism and who made a grave mistake by doing drugs,” he said.
The B.C. Coroners Service detected alcohol in about 26 per cent of illicit-drug overdose deaths over the past three years.
Managed alcohol programs improve the lives of drinkers, according to researchers at the Canadian Institute for Substance Use Research at the University of Victoria.
They studied one of the programs in Thunder Bay, Ont., (there are 14 across Canada now) and found that participants experienced improvement in housing, mental and physical well-being, reductions in alcohol-related harms, decreasing non-beverage alcohol use and more stable patterns of drinking.
Participants said they experienced 40 to 80 per cent fewer police contacts and hospital and detox admissions. Hirsh said with the PHS program some people find a starting point to moderate their drinking and some even go into detox and recovery.
But the alcohol use of the patients for whom she cares is part of a chronic, relapsing disorder — and sobriety is not the primary goal.
“Often (their drinking is) for reasons that we do not understand and the best thing we can often do for people is support people in their journey and hope to see them evolve to recovery or to a better place, but to also be there to catch them when they fall,” she said.
Hirsh said she wants people to be better off than when they first walked into the lounge. She thinks about how they and their loved ones have suffered.
“When it comes to alcohol-use disorder, people often throw up their hands,” she said.
“I think if I had a family member going through this, knowing that there was a place where they were respected and cared for, and could be themselves, could be checked on and could be safe ... is of huge value.”