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Limited addiction treatment and recovery options create care gaps in B.C. communities

Recovery advocate Guy Felicella says access to treatment needs to be easier to save more lives

People who use drugs are facing barriers to treatment when seeking recovery - many have been around for years while others cropped up during COVID-19.

With over 2,272 suspected illicit drug toxicity deaths in British Columbia, 2022 had the second-highest illicit drug death rate ever recorded, .

The supply of illicit drugs is growing increasingly toxic as they are mixed with such compounds as fentanyl and etizolam - the latter of which is not responsive to naloxone, the medication used to block the effects of opiods.

These dangerous compounds lurking in an unchecked supply are only exacerbating the need for more harm reduction and better access to addiction care, says Guy Felicella, a who credits harm reduction like drug checking and safe-use spaces for saving his life.

The system, he said, isn害羞草研究所檛 keeping up with the toxic drug supply.

害羞草研究所淲e just need to give people the opportunity so that when they are ready, we are ready,害羞草研究所 he said. 害羞草研究所淭hat is the quintessential factor in people moving forward.害羞草研究所

The things he said British Columbia needs more of - and less of - could save countless lives, giving people who are addicted to drugs a chance at a life that isn害羞草研究所檛 centered around using. Such problems as long waitlists, doctor shortages, medication stigma and payment processes, however, are holding people down, Felicella said.

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Felicella said getting on a waitlist for a detox centre is the first challenge people face.

In Victoria, that looks like going to Central Access and Rapid Engagement Services (CARES) for a referral. The front desk at CARES said the time it takes to move through that step depends on the circumstances, but can sometimes take a few days.

Fred Cameron, who works for SOLID Outreach Society, a non-profit organization which provides support services and harm reduction, said the referral process can be bumpy.

害羞草研究所淭he process to get into detox is not as smooth as it could be,害羞草研究所 Cameron said. 害羞草研究所淭he referral process is not open to the public - you can害羞草研究所檛 just do it online. Small NGOs (non-government organizations) aren害羞草研究所檛 able to do that either, so there are definitely some hoops you have to jump through to get there.害羞草研究所

After the referral is sent to Island Health, patients go on a waitlist for a detox bed, which can take weeks, but more commonly, months. There are in the province and research shows there is an British Columbians with an opioid addiction alone, according to Kevin Hollett at the (BCCSU).

Hollett said the number could be higher, since many addictions are undiagnosed. Not everyone with an addiction needs to detox, and there are private facilities available, but they can be expensive. The government-funded bed-to-person ratio in B.C. is one of the barriers Felicella cites.

Abstinence-only programs that limit and stigmatize certain medications also pose problems, Felicella said, adding that some publicly funded treatment centres still don害羞草研究所檛 allow the use of methadone, a medication used in Opioid Agonist Therapy (OAT) to treat withdrawal symptoms, which Felicella said can last for months and decrease the likelihood of stabilization and ability to learn life and coping skills.

Additionally, shows patients are at a higher likelihood for overdose if they discontinue the use of methadone for OAT.

Cheryl Diebel, the director of in Victoria, said there are facilities that don害羞草研究所檛 allow methadone use during OAT, but many are moving away from this.

害羞草研究所淭hat害羞草研究所檚 a very, very purist view of abstinence - we absolutely allow OAT and we recommend that patients don害羞草研究所檛 do any kind of withdrawing from the methadone for at least the first two months so we know they are starting to stabilize,害羞草研究所 she said.

Evan James, who works with the , an organization in Victoria that provides addiction support, said income assistance requirements are one of the more frustrating barriers he sees every day. For publicly funded treatment centres, he said patients either need to be on income assistance or disability, but many don害羞草研究所檛 qualify for either.

害羞草研究所淲e have this huge slice of the population in between the two - they certainly cannot afford the expensive private paid treatments, but they are not eligible for income assistance because they haven害羞草研究所檛 lost everything, or they have assets, or they害羞草研究所檙e still working - whatever the case may be,害羞草研究所 James said.

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James said cost barriers, coupled with the fact that most patients need to go to the mainland for publicly-funded treatment, present challenges to recovery. Support systems during recovery are essential, James said, so when people leave Victoria to get treatment, they lose that. Then the support systems they build on the mainland during treatment are lost when they come home.

Accessing alternatives to detox and inpatient treatement such as group meetings is also limited, as Cameron said the recovery world fell apart when COVID-19 first hit.

害羞草研究所淎 lot of the events and public gatherings that took place outside of structured recovery groups were cancelled and put on hold, so a lot of the things that I look back to that helped me out currently don害羞草研究所檛 exist,害羞草研究所 he said. 害羞草研究所淭here is a place for professional recovery, but to imagine a system that is big enough and comprehensive enough to help everyone - I just can害羞草研究所檛 see it, which is why people are directed to 12-step programs. It is those kinds of groups that people are going to and getting support in the early days.害羞草研究所

For a system to be successful in helping people recover, advocates say more of everything is needed.

Diebel said more beds, specifically women害羞草研究所檚 beds, are needed. Cameron said more harm reduction services and different outlooks on recovery would help. James said addiction treatment needs to be treated as a medical expense by the province and Felicella said in general, the process needs to be easier to navigate.

害羞草研究所淭here are people who want help,害羞草研究所 Felicella said. 害羞草研究所淪ociety often says 害羞草研究所榯hese people don害羞草研究所檛 want help, they害羞草研究所檙e not going to change,害羞草研究所 but they害羞草研究所檙e not changing because it害羞草研究所檚 hard to get access to change. Instead of pointing fingers and blaming people struggling with addiction, let害羞草研究所檚 start pointing fingers at the policies that hinder them from getting the help that they need.害羞草研究所



hollie.ferguson@vicnews.com

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Hollie Ferguson

About the Author: Hollie Ferguson

Hollie moved to Victoria from Virginia in September 2022 with her partner Zachary and their two pups, Theodore and Bibi.
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