Hamilton becoming a hub for addictions services

They come from Grimsby, Guelph, Toronto, Niagara, and even as far away as Kingston.

People from all over the province are coming to Hamilton to seek help for their addictions. Right now, about 15 per cent of the people who are enrolled in St. Joes addictions services are coming from outside the city.

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Industry professionals point to Hamiltons burgeoning medical industry and say that just like other medical fields, patients are gravitating to the city to make use of addictions services that are unique and leading the way in Canada. In some cases, it's as simple as staying open later and being open on weekends. In others, it's programs that are tailor-made for certain groups that are extremely rare in the rest of Canada.

Some say Hamilton is burdened by excessive social services in the core that its a dumping ground for mental health issues, addictions services and halfway houses. But the people running these programs say that the city's addictions programs could be used as an example in other centres as some of the best practices for helping people.

Why shouldnt they be in Hamilton? Where would you rather they be? Should we ship them down the road?- Sue Kennedy, executive director of Alternatives for Youth

Were one of those centres, said Debbie Bang, the manager of St. Josephs Healthcare Womankind addictions service. We are an incredibly unique service.

Womankind is one of the only women-only addictions services in all of Canada, Bang says. Being a women-only service can be vital to recovery, and that means that women sometimes have to travel to get the help they need, so they come to Hamilton.

In Hamilton, they find a continuum of care thats unlike most places, Bang told CBC Hamilton.

The uniqueness of Womankind in Canada is that most women or men have to go one place for their withdrawal management, another place for their treatment, perhaps the same place for their aftercare, but not necessarily, she said. They break up all those different parts of what really is somebody getting better. We keep them all together.

Its a very inclusive service that invites women to be involved with us for the longer term, and helps to ensure that theyre solidly on their feet when they are walking that road of recovery. Its not an easy path.

Being 'service rich'

St. Joes isnt making a concerted push to get people from outside Hamilton into care here, Bang says. But according to their research, word of mouth just keeps spreading drawing in people who are trying to get off drugs.

We are definitely service rich, agreed Sue Kennedy, the executive director of Alternatives for Youth, an organization that provides substance use counselling services for young people. Alternatives for Youth is the only specific children and youth community-based education service in the province, Kennedy told CBC Hamilton.

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Other places do have youth addictions services, Kennedy says, but theyre usually attached to programs for other age groups. But at Alternatives for Youth, the staff only deals with young people. Thats exclusively what we do, she said. And you have to use very specific strategies to engage youth.

About 800 young people seek counselling at her organization a year, running the gamut from alcohol problems and opiate use to crack and cocaine addiction. She says there is a broad need for counselling and addictions services in the city. Its visible and very obvious, she said.

Dr. Jaswinder Dhillon is a managing partner and doctor and the John Street Methadone clinic. He told CBC Hamilton that patients are definitely coming from outside Hamilton to use our addictions services.

I do know people come from other places, he said. Its partly the capacity Hamilton has built. The infrastructure exists.

Hamilton is a medical hub in the region, so it makes sense.

The 'dumping ground' effect

What sets the John Street clinic apart from most other methadone clinics is its access and hours, Dhillon says. There are almost no opiate suppression clinics in Ontario open on a Sunday, or that keep early and late hours. At the John Street clinic, they do both, as a high percentage of patients are also working.

A lot of communities dont have that access available, he said, adding that 3,500 people are using methadone in Hamilton.

Methadone is used to wean people off opiates, and effects opiate receptors in the brain. It essentially mitigates withdrawal symptoms, which can be devastating when a person is trying to get off heroin or an oxycodone product.

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If a patient misses more than three days on methadone, they have to restart the program a definite deterrent to getting clean. At the John Street clinic, there are eight doctors available to see patients, meaning they can usually get in the next day should they miss an appointment.

A lot of clinics dont have that kind of access, Dhillon said.

But not everyone sees the citys wealth of addictions services as a positive. During the debate on St. Leonards Society of Hamilton halfway house renovations in October, Ward 8 Coun. Terry Whitehead called Hamilton a regional dumping ground for social services and mental health cases, including newly released inmates.

Councillors also expressed relief when the federal government announced an infamous halfway house on York Boulevard will move from downtown in 2014. It had been controversial since 2004, when a resident walked across the street to Jackson Square and stabbed a female shopkeeper nearly to death. There have been other instances of residents with violent records walking away from the facility.

Whitehead told CBC Hamilton that the city is a regional hub for health care services, "which is both a blessing and a curse at the same time." While it may be great that Hamilton has the ability to help people from other centres, he says, more support is needed from other levels of government to deal with the financial implications that spin out of that.

Whitehead says sometimes he's accused of being insensitive when he makes that argument. "I want to be clear I'm not saying that we don't do it," he said. "But the cost shouldn't come on the back of property taxpayers in this community. It should come from other levels government."

"We're doing a disservice to the taxpayers of Hamilton."

The city needs more "empirical data" on who is using Hamilton's services and where they're from, and then use that data in talks with other levels of government about funding possibilities, Whitehead says.

Dhillon maintains that Hamilton can be used as a model for what other cities can do when it comes to social services. And look around downtown theres lots of improvements happening. I dont feel unsafe.

Kennedy says the sometimes-negative perception about social services in Hamilton exists because they're highly concentrated in the downtown core, whereas in a place like Toronto, theyre more spread out. Its not hidden, and it may be more hidden in other communities.

But why shouldnt they be in Hamilton? Where would you rather they be? Should we ship them down the road? she asked.

What we need more than anything is a compassionate community response.