Treating the disease of addiction

Dr. Jeff Turnbull wanted to see what the Yukon offers its alcoholics and addicts. The president of the Canadian Medical Association was up here for a meeting this month to talk about health-care transformation.

Dr. Jeff Turnbull wanted to see what the Yukon offers its alcoholics and addicts.

The president of the Canadian Medical Association was up here for a meeting this month to talk about health-care transformation.

In November, the last time he was in Whitehorse, Turnbull was to talk about health-care transformation.

Instead, he talked about caring for society’s down and out – addicts who spend most of their time on society’s periphery.

This time around, Turnbull talked about transformation, but made time for some other meetings as well.

One of them was with Dr. Bruce Beaton, who spent 30 years in the emergency room at Whitehorse General Hospital and co-authored a recent report on the Yukon’s “acutely intoxicated persons at risk.”

Beaton gave Turnbull a tour of the Yukon’s drug and alcohol facilities.

“I took him to the detox centre (which is not a medical detox) and the Salvation Army,” said Beaton.

The pair also drove by the jail and visited Kwanlin Dun’s health centre, which does not have an alcohol or drug program.

“Was Turnbull ‘wowed’ by what we have? Of course not,” said Beaton.

“He was not overly impressed with what we are doing, because – as I said in my report – we are still doing stuff the way we did in 1890.”

In the Yukon, alcoholics are treated as criminals.

But “it is no longer acceptable simply to detain the intoxicated person,” wrote Beaton in his report.

It “reflects neither the social norms nor the human rights standards of today.”

In his 32-page report, given to Health and Social Services on December 31, Beaton made 12 recommendations that included building a new sobering centre and medical detox in the downtown core, rewriting the Yukon Liquor Act, creating a street outreach team and building a shelter that accepts intoxicated clients.

The report also recommends treating society’s down and out “with compassion and dignity in a nonjudgemental manner.”

There is a mindset that alcoholics and addicts “are not good people,” said Turnbull.

“But it is an illness.”

And when you look at alcoholism as a disease, “it’s a lot harder to walk past people on the street,” he said.

This month, BC became the first jurisdiction in Canada to recognize and treat addiction as a chronic disease.

It’s something Turnbull has been practising for more than a decade.

In Ottawa, Turnbull has created a safe haven for the homeless and addicted.

His shelter system includes medical detox, doctors, nurses, soup kitchens, beds, a managed-alcohol program, clinics and even vets for the addicts’ furry companions.

Every year, these shelters save Ottawa Hospital – where Turnbull works – more than $3.5 million.

“We took more than 200 people out of the ER,” he said.

“These guys were in there up to 18 times a month, and calling the ambulance up to 13 times.

“Now, no one calls the ambulance or goes to the ER.”

The Whitehorse General Hospital is overrun with regulars – chronic alcoholics who visit the emergency room at least a couple times each month.

“Nobody wants to take responsibility for these people, so they bring them all to the ER,” said Yukon Medical Association president Dr. Rao Tadepalli in a past interview with the News.

But the hospital doesn’t have “the staff, security or space” to deal with them, he said.

After 30 years at the hospital, Beaton is well aware of the problems.

His report’s No. 1 recommendation – which he stressed should take precedence over all others – was to “alleviate rapidly the staffing and physical resource crisis” caused by “acutely intoxicated persons at risk in the emergency department.”

“I would love to see the government move quickly on many of the recommendations in Beaton’s report,” said Turnbull.

So far, the only action taken has been to announce a new secure assessment centre will be built at the jail to deal with the acutely intoxicated in custody.

Beaton’s report warned against such a facility.

“If any future facility is to play a significant role in the lives of (the chronic alcoholics and drug addicts), it must be accessible and available to the people it serves,” says the report.

Building a secure assessment centre at the jail, in Takhini, “is not central,” it says.

“Nor is it a part of either the social community or the treatment community.”

It is not a medical detox, also recommended in the report.

It will not be attached to a detox, which was recommended.

And it will only accept people who have been picked up by the RCMP.

In the Yukon, alcoholics are still treated as criminals, said Beaton.

It’s an attitude that’s been in place since the Gold Rush, he said.

But once you get to know people and understand what led to addiction, “you realize there are few circumstances where this is a choice,” said Turnbull.

“When you are given alcohol at 12, by your only parent, to keep you quiet while they go out, is that a choice?

“Is fetal alcohol syndrome a choice?

“No one wakes up one day and decides to be an alcoholic.”

Turnbull sees his patients as individuals.

Some are artists, some have families, some share funny stories and some beat you at euchre, he said.

And some die.

“They are struggling with a serious illness and are at a great risk of self-harm,” said Turnbull.

“We try to minimize it, but we can’t make it zero.”

Bill died recently.

“Bill used to play cards with me, and he loved Christmas,” said Turnbull.

After Bill died, a family member wrote Turnbull.

Her letter, which follows, was printed in the Montreal Gazette on March 31:

“I read the story about Ottawa’s The Oaks “wet” treatment facility with great interest. My cousin Bill was in this program until this past summer, when he fell down and hit his head and died.

“We, his family, were shocked to a degree, but it wasn’t totally shocking, if you get my drift. We all knew Bill would probably succumb to his alcoholism at some point.

“Bill had been one of those people described in the article. He lived on the streets for more than 20 years. Many people asked us why didn’t we take him in. That had been done and failed miserably. You see, Bill had his mental-health issues that made living in a ‘normal’ home impossible.

“He was a drug addict as well. No one with kids can have that.

“So eventually Bill was chosen for The Oaks. He did well there. He finally had a tiny place to call home. The pressure of day-to-day living on the street was gone. He settled in and started to repair his relationships with his kids and family. He even had his first grandchild while there.

“So when Bill died, it was probably sadder than it would have been had he been living on the streets.

“The Oaks had a service for him, and welcomed us with open arms. I got to meet some of ‘his people.’ They were so gracious.

“I wasn’t sure how I felt about this “wet” program before, but I support it after seeing how well my cousin did there.”

The Yukon needs a sobering centre linked to a medical detox, said Turnbull.

And it needs to be downtown, where the individuals live, he said.

Turnbull would love to see construction start “today”.

“But sometimes these things take awhile to sink in,” he said.

“But will it happen in six months – no,” said Beaton.

“Next year – no.

“Even in three years?

“We need a significant change in attitude,” he said.

“But I am hopeful that something will ultimately happen.”

Contact Genesee Keevil at

gkeevil@yukon-news.com

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