Longer waits, fewer treatment beds and one Manitoba man's struggle for help with fentanyl use

It's a cold April morning and Lee Earnshaw is wrapped in a blanket inside a tent along the banks of the Seine River.

The 42-year-old father and former commercial fisherman has been living here since December after starting to use drugs again.

"I've been addicted to heroin, and lately, fentanyl," he said. "I had three years clean til last year…. I dabbled again, and just you can't dabble, or I can't. It's something I just have to stay away from."

An outreach team with St. Boniface Street Links comes by each day to check in with Earnshaw. On this morning, they bring coffee and a new naloxone kit. He is grateful because he recently used his supply of the overdose antidote.

"I just about lost my partner the other day," he said. "That was scary, that kind of really made me want to stop…. I don't think I could live with myself if I was the cause of somebody's death."

Barriers to supports and services have only increased for people who use substances during the pandemic.

In Manitoba, many of the province's non-medical withdrawal management and residential recovery centres have had to reduce the number of beds available to ensure physical distancing, a provincial spokesperson told CBC News via email.

As a result, wait times for admissions are "longer than normal", the spokesperson added.

Earnshaw said he wants to get help, get back to work and see his family again. He has tried to access support for his substance use in recent weeks, but said it has not been easy.

Twice in recent weeks, he visited a Rapid Access to Addictions Medicine clinic in Winnipeg with members of the outreach team, but said he had no success.

"There was some issue, I had used [drugs] within 24 hours or something," he said. "It's kind of disappointing because you psych yourself up, you're ready to go."

I think the system ends up kind of rolling the dice on peoples lives here,- Marion Willis, founder of Morberg House

On another occasion, the clinic had reached its capacity for appointments, according to the outreach team. Earnshaw said he plans to keep trying and he wants to get into a detox centre.

Fewer detox and treatment beds, longer wait times

In Winnipeg, just 17 of 29 non-medical withdrawal management beds for men are operational. The current wait time for a spot is more than three weeks. Meanwhile, 20 of the 26 non-medical detox beds are open for women, with a five-week wait time.

In Thompson, half of the city's six beds are operational with a two-day wait. In Brandon, all six non-medical detox beds are operational and come with a 23-day wait time.

"I think the system ends up kind of rolling the dice on people's lives here," said Marion Willis, founder of Morberg House and St. Boniface Street Links, which provides transitional housing, mental health and long-term addiction support to men in Winnipeg. "We must do better."

Willis said people seeking help for substance cannot be made to wait and she fears the reduced access to services will continue to cost lives.

The province's medical withdrawal management beds, 11 in Winnipeg and two in Brandon, are operating at full capacity, the spokesperson said. However, priority is reserved for the highest-risk patients, such as those in danger of life-threatening complications due to withdrawal.

Klinic also offers a mobile withdrawal management service to support up to 10 people a month who are withdrawing from substances at home, or in the community, with a wait time of seven days. 

Meanwhile, most residential recovery centres in Manitoba have reduced primary bed capacity by 10 to 25 per cent, the spokesperson said. Wait times right now range from 45 days for men and 119 days for women.

Fatal overdoses spike in Manitoba 

In 2020, 372 people died of drug overdoses in Manitoba — an 87 per cent increase over the year before. The majority of those deaths were linked to opioids, including fentanyl.

Experts say a toxic street drug supply, an increase in people using drugs alone and barriers to supports and programs during the pandemic are some of the factors behind the surge in fatalities.

Willis said the province's pandemic planning did not seem consider the drug epidemic and effects it has had on services for people who are vulnerable.

"We would have looked for ways to create more detox beds, not less. We would have looked for ways to engage more people in treatment, not less," she said. 

On top of expanding access to detox and treatment, Willis and other advocates are calling for increased harm reduction including safe consumption sites and a safer drug supply.

Manitoba is the only province west of Quebec without safe consumption sites.

Earnshaw agrees the facilities would be helpful and save lives. 

Minister responds

In a phone interview with CBC News, Audrey Gordon, Manitoba's new Minister of Mental Health Wellness and Recovery, said creating the department of Mental Health, Wellness and Recovery was the provincial government's first step in its commitment to improving services.

"I think it's to our government's credit that we have established the ministry," she said. "Is there more work to be done? Absolutely."

She said she recognizes facilities have had to make adjustments during the pandemic and capacity is expected to return to pre-pandemic levels when restrictions are lifted. 

In the meantime, she said she is talking with service providers and other stakeholders to see where the needs are.

Gordon said there are many initiatives on the horizon, including an announcement she made in April about the creation of 21 supportive recovery housing units in Brandon and Thompson. It's in addition to 70 supportive housing recovery units announced last June to be developed in Winnipeg, she said.

She also pointed to the province's commitment to create more withdrawal management beds in Manitoba in the coming years. It was one of several recommendations identified in the 2018 Virgo report, a lengthy review of Manitoba's mental health and addictions services.

A new six-bed unit at the Health Sciences Centre, which will provide care for patients in various stages of intoxication, withdrawal or mental health crisis is also slated to open this winter. 

"I want people to know that we are taking an evidence-informed approach to the services and programs that we provide," she said. "We are going to be rolling out many initiatives in the next few months."

When asked, Gordon did not say whether the provincial government is considering implementing safe consumption sites or a safe drug supply.

Earnshaw believes Manitoba's drug crisis is only likely to get worse.

He points to British Columbia, where he moved from in recent years to get away from heroin, which has been the epicentre of the drug poisoning crisis. Last year marked that province's deadliest year for overdoses on record.

"It's only going to get that way here," he said. "[Drugs are] going to get cheaper and it's going to get more and more available. The sooner they start doing something about it, the better."