Health

Should detox clinics have to be smoke-free?

by Rob Peters | August 5, 2008 at 01:22 pm

533 views | 2 Recommendations | 6 comments

Canadian drug treatment centres and mental health facilities have typically held the view that patients trying to wean themselves off hard drugs shouldn't try to quit smoking at the same time. The cultural shift toward public smokelessness, however, has put that received wisdom into question.

Many health practitioners are asking themselves a difficult question: should facilities that try to help people deal with severe drug and mental health problems be exempt from restrictions that affect other public places?

In my view, absolutely. For people dealing with heroin addiction or severe schizophrenia, smoking is sometimes the only available relief during a difficult course of treatment. Smoking is the much lesser of two evils.

Derek Laughlin, a 40-year-old former crack addict from Vancouver's Downtown Eastside, found the cravings unbearable. Hours into treatment last year at a Surrey, B.C., short-term detox centre, on a staff-supervised walk around the block, he fell behind the group to search the pavement for discarded cigarette butts.

Overcoming his crack habit was tough, but simultaneously giving up smoking was too much, Mr. Laughlin says.

"It was brutal," he says. "I'd be searching for cigarette butts wherever I could find them ... and stressing out over when I was going to get another smoke."

Canada has entered the next frontier for smoking bans: Many addiction facilities, forensic psychiatric hospitals for convicted criminals and federal prisons have recently banned smoking, sparking a heated debate among health practitioners about what is more important - weaning patients off cigarettes or helping them break free of hard drugs.

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eastvanray

flagged this story as Good Stuff

at 13:40 on August 5th, 2008

Rob Peters, I like this story. It's good stuff.

I can't say I am convinced of the logic here. If it is too difficult to quit both heroin and nicotine then it must follow suit that it is also too difficult to quit both heroin and cocaine. Do these detox specialists treat heroin first but allow the addict to continue using cocaine? What about heroin and meth or meth and oxy? And drinking alcohol...are addicts allowed to drink alcohol in these detox centres? It would seem to me that nicotine and alcohol should be treated similarly. Why make an addict go through detox and withdrawl multiple times? Get clean all at once and these addicts are spared the high possibility of quitting one drug but still being addicted to others.

Jill. Coleman

at 03:52 on August 6th, 2008

Oliver, a recovering heroin addict. Taken at Serenity Care Centre, Sedgefield, South Africa, for the treatment of alcohol and drug addiction.

Jill. Coleman has contributed a photo to this story.

cbowden

at 13:53 on August 6th, 2008

Items from a nursing students lab kit.

As a student entering the health care profession, I can understand the heated debate regarding the ban. We are taught, as nursing students to follow the principles of harm reduction. Therefore, if a patient is finding that nicotine helps them cope with the cravings for harder substances and prevents a relapse of use, the health care professional weights the pros of their smoking against the cons.

I completed a short rotation in a mental health facility dealing with patients with substance dependence, and smoking was permitted outside on the hospital grounds in designated areas. This seemed to work for both patients and staff.

Peanuts_Photography has contributed a photo to this story.

eastvanray

at 14:59 on August 6th, 2008

I guess that makes some sense. Would an alcoholic be allowed to drink while in treatment? I would think alcohol and nicotine (both being legal) should be treated equally.