Mary Marlow

For the vast majority of those who want to detox - get drugs out of their system with the assistance of a medical professional - there is no wait to access the service.

  That's the surprising message from Mary Marlow, Manager of Withdrawal Services, Vancouver Community Health Services. While the common belief is that drug users must wait significant amounts of time to enter detox, Marlow says that about 80 per cent of people get into detox within 24 hours of contacting a health professional or calling the special detox phone line in Vancouver .

  But Marlow stresses that acceptance into a residential program is not the only way to detox. In fact, she doesn't see the need for more beds (other than a couple of medical care beds for youth, which are set to open at Vancouver Detox in April) because she sees the growth of home detox programs as a positive development offering detox services to more people. "Detox is not a place that you go to; it's a process you go through."

  Most people detox in their own home, Marlow added.

  When Vancouver Coastal Health (VCH) reorganized detox services in Vancouver in 2002, it consolidated a variety of different kinds of detox services and created one phone line to access all detox services. Those wanting to detox now may call ACCESS 1, to access detox services. Staff screen callers and then try to find them an appropriate detox bed or refer them to a detox service. Most are able to enter detox within 24 hours; others must wait a day or two, depending on their personal situation.

Last year, VCH added an ACCESS 1 kiosk at The Contact Centre, behind the Carnegie Centre in the Downtown Eastside, which gives those without a phone an opportunity to call the toll-free number and find out when and where they can enter detox.

Youth, if they prefer, may call the dedicated youth line, D-Talks.

Some drug users choose to detox at home, with nursing support. They may be referred to their local Community Health Centre (CHC), as each Vancouver CHC offers addiction services, including home detox.

Vancouver Detox, which is run by VCH, includes 24 beds, has a physician available every day and offers 24-hour nursing care. This facility is generally used for those requiring medication to get through the detox process. It also offers acupuncture which, Marlow said, "makes a huge difference." She said that with acupuncture, clients require less medication, get through their withdrawal a little easier and tend to stay until they are completely detoxed.

Harbour Light also offers detox services. Run by the Salvation Army, it offers 29 residential beds, for a five to seven-day detox program for those who have no home or lack the 24-hour support they require to get through the detox process.

Along with traditional medical care, it also includes acupuncture.

Detox is not a place that you go to; it's a process you go through.

Both Harbour Light and Vancouver Detox also have an income assistance worker from the Ministry of Employment and Income Assistance at each site for two days a week. "That's new and that's really helped a lot of people leave detox and get into supported recovery housing or treatment." The ministry staff also assist clients to get on income assistance. Marlow praised the ministry for its efforts to help detox clients with their planning for post-detox.

Marlow said Vancouver Detox also started running a Daytox program in 2001, based on a model from Portland , Oregon . It's a six-week program, starting with acute detox, which lasts from five to seven days but can last for as long as two weeks. They then move into attending day programs.

Those in the Daytox program visit the program to determine how they will get through the detox process and move forward with their lives. Staff educate them on the cravings, mood swings, depression and sleep problems they may experience during and after the detox process.

They also have access to acupuncture, qigong (chi gong), art therapy and therapeutic touch.

Clients are expected to attend the program a minimum of 10 hours a week, choosing their activities from those offered by the program. "The most well-attended groups are the alternative therapy groups," Marlow said.

Vancouver Detox's Daytox Program is open from 9 am-9 pm seven days a week. About 100 clients are signed up but the room can only hold 20 people at a time. "It's a tiny space; we need more space." Marlow would like to see the Daytox program expanded to more locations, including one on Commercial Drive specifically for youth.

  Vancouver Detox also offers sobering services. Those found drunk and unconscious are brought to Vancouver Detox for a minimum of four hours. Staff monitor them and, when they awake, offer them services. Most do not stay to detox.

  Marlow said that while Vancouver is probably close to the number of detox beds it requires and the home detox programs are taking care of a lot of the detox needs of Vancouver drug users who want to stop taking drugs, there is a serious need for "pretox" services, similar to what's already offered in Toronto .

  A pretox service would give drug users who are considering detoxing a quiet place to stay voluntarily. There, they could sleep, would receive regular meals and would be monitored by staff, who could also help them with medicine, as needed. If they choose to go through detox, they could do so when a bed becomes available.

  Focusing on youth, Marlow said that the wait for youth detox is usually low, at most about 24-48 hours. There are 14 detox beds for youth at DEYAS Street Youth Detox, Family Services Youth Detox and PLEA Youth Detox Program combined. Most youth do not require medical care through detox but the addition of two new medical care beds for youth - planned to open at Vancouver Detox this April - means that option will now be available to youth who require it.

  She added that housing for youth is also a big issue. Youth often need somewhere to go after they've gone through detox. Of course housing is also a urgent issue for many adult clients as well.