Should detox clinics have to be smoke-free?
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.