Next Up.......Safe Drinking Establishments

Tuesday, April 29, 2008

VANCOUVER - For the past five months, the Frank Paul Inquiry has focused on why Paul died in a cold, wet alley and why his death wasn't properly investigated.

But on Monday the inquiry switched its attention to what could be done to change how B.C. deals with such homeless, chronic alcoholics.

It heard about Toronto's "safe-drinking site" and "wet shelter," where chronic alcoholics drink under supervision, or are actually dispensed some wine to drink.

Paul was an aboriginal man with a long history of arrests for public drunkenness and was found insensible on top of a vegetable stand in December, 1998.

He was taken to Vancouver city jail where an officer refused to accept him, saying he wasn't drunk. He was dragged back to the police wagon transported to an alley and left until found dead from exposure some hours later.

The inquiry, which began in November, entered the fourth phase of its deliberations Monday with Commissioner William Davies seeking information on policies and procedures used by the Vancouver Police department and other public agencies in their treatment of chronic alcoholics or drug-dependent persons.

A presentation was made by members of Aboriginal Legal Services of Toronto, which involved a team of medical and social service experts describing how Toronto uses a safe-drinking site for its homeless and chronic alcoholic population whose behaviour mirrors that of Paul.

Dr. Tomislav Svoboda, a family physician who works in the Seaton House Annex Harm Reduction Program, said the annex has 130 beds and was quietly opened in 1997. It provides shelter for the homeless, chronic alcoholic, provides subsistence amounts of alcohol and gives the alcoholic an alternative to living on the street.

The shelter was created in the aftermath of three homeless persons freezing to death in the winter of 1995, resulting in a public outcry. At the time, welfare regulations precluded anyone deemed an alcoholic from receiving benefits, Svoboda said.

"The poor in Toronto essentially lived in prohibition. Many individuals were forced to make a decision between shelter and use of a substance," Svoboda said.

A coroner's inquest into the deaths resulted in a recommendation that a "wet shelter" be set up in the city.

Svoboda said the annex operates in conjunction with the Toronto Infirmary as many of the people staying there have serious medical conditions as a result of their addiction.

This population was 30 times more likely to use hospital emergency services than the average citizen, he said.

Following the introduction of the "wet shelter", the number of hospital visits from this group dropped by 84 per cent and the time spent in prison was down by 100 per cent, Svoboda said.

People enter the program on referral, said Art Manuel, who manages the annex.

The amount of alcohol provided is dependent on a medical evaluation but in some instances allows for a six-ounce serving of wine dispensed every 90 minutes.

"It could amount to a couple of bottles a day," Manuel said.

The shelter also provides food, medical help and overnight shelter. Some clients spend a considerable time there. "We've had one fellow who has been there 10 years," Manuel said.

Svoboda said people admitted to the centre had passed the point of being able to manage their addiction. He said the idea was to limit the harm they were doing to themselves by drinking such things as cooking wine, mouthwash and rubbing alcohol.

He admitted some people felt a moral distaste for providing such services to chronic alcoholics, and society was making it too good for them. "But that's not the case, people in this situation are suffering," he said.

Asked by Davies if he had any recommendations, Svoboda admitted his program was not perfect, but it was useful. "People shouldn't be repelled from seeking shelter because they use alcohol," he said. "We need supportive housing and an appropriate level of harm reduction services. If you set the bar too high for housing you'll eliminate people."

SFU Criminology Professor Neil Boyd told the inquiry that he had studied a number of recent in-custody deaths of people intoxicated with alcohol or drugs in B.C. Overwhelmingly, coroner's juries had recommended greater access to medical help and improved liaison between police and medical authorities, Boyd said. (When Paul was dragged unconscious into the jail, there was no attempt made to have him examined by a nurse of doctor.)

Boyd said he was impressed by the consistency of the recommendations for medical intervention, better video monitoring of cells and changes to procedures for handling the intoxicated. He said it was obvious that when the police find people suffering from a drug overdose they are likely to be taken to hospital, but that wasn't the case for alcohol intoxication, especially if they were found in the Downtown Eastside.

"If someone was found drunk at 45th and Maple, they wouldn't be taken anywhere other than a hospital," Boyd said.

The inquiry continues.