No date for reopening of Moncton's in-patient detox centre as addiction crisis deepens
Detox is first step for many in recovery, but Moncton’s 10 beds have been closed since July
Keisha Daley bundles together piles of alcohol swabs, sorts packaged needles and hands out supplies to people injecting drugs.
She works part time as a peer support counsellor at Ensemble Moncton, where there is a steady flow of people with addictions walking through the doors looking for help. Even when the non-profit is closed, dozens gather to sleep on the front porch, and in the back parking lot.
In Moncton, homelessness and addiction are visible to anyone who passes through the downtown. With the city's in-patient detoxification unit closed, and a lack of affordable housing, people who want to recover say the challenge of getting and staying sober can seem nearly impossible.
Daley, 34, who is trying to recover from addiction herself, lives in a shelter.
"You see how other people are on drugs and you don't want to be like that anymore," she said of her decision to try to quit.
"It's very difficult to try to get yourself out of addiction, because you end up falling back into it every time. Because you're surrounded by it."
Front-line workers like Daley work with hundreds of people living on the streets of Moncton. Many are struggling with opioid addiction and mental illness. Ensemble operates the city's only supervised injection site and staff there say the problem is only getting worse.
First responders are dealing with a spike in opioid overdose calls, with the fire department responding to four to five incidents per day. In Moncton, fire Chief Conrad Landry says there has been about a 40 per cent jump in overdose calls in the past three years.
Crisis worsens
Every weekday morning, people line up outside the St. George's Anglican Church for a warm breakfast and a shower.
Last summer, volunteers were serving breakfast to about 15 people. In one year, that number has grown to more than 100.
Nancy Urquhart helps out in the kitchen, pouring hot coffee, serving bowls of cereal and handing out bananas. The tables in the church basement are full and in the corners, some people are sleeping.
"We're not here to judge them, we're here to feed them," she said.
Urquhart said based on what she sees every morning, Moncton's addiction crisis is worsening. Needles are scattered on the church lawn and people are injecting mere steps away from the doors to the breakfast program.
"They'll come in here and tell us that someone has overdosed, or somebody is not conscious anymore," she said. "It takes you back, because it's a life."
'Senseless deaths'
New Brunswick's rate of drug-related deaths is the highest ever recorded. A 2022 report from Public Health found 86 people died from overdoses last year — more than double the total from just five years earlier.
Riding his bike on the streets, Mickey Maguire keeps an eye out for people slumped over or in distress. He also regularly visits the church basement for breakfast.
"It's to the point where people, they're nonchalant about it, they'll just be sitting out in the open and lighting up a pipe with fentanyl in it or crystal meth, or even injecting," he said.
"There's a lot of deaths. Senseless deaths that shouldn't be happening."
In a room at Ensemble's supervised injection site, there's a wall displaying photos of the faces of people who have died on the streets, many from overdoses.
Maguire, 47, is a full-time peer support worker at the facility and now a trained first responder. He's also homeless, and trying to recover from addiction.
"I thought if I'm going to help people with their lives, maybe I should try and work on mine too at the same time. I'm still currently using, but not like I used to."
Maguire is on the waiting list for public housing, and said the path to recovery is even more difficult without a roof over his head.
It's been a struggle to find treatment options to turn his life around.
'They've given up'
Moncton's only in-patient detox centre, which treats seven to 10 patients at a time, was once the place many people went to begin their recovery. It has been temporarily closed since July 3, due to an ongoing shortage of available nursing staff.
A stay in a detoxification centre usually lasts between two and 10 days. Nurses and counsellors help people manage the worst of their withdrawal symptoms, and plan next steps in their treatment.
In many cases, Maguire said detox is a "stepping stone" for people who want to turn their life around, but there is currently no facility for front-line workers to refer people to.
Debby Warren, Ensemble's executive director, said many of her clients have no place to go to start their journey to recovery.
"I wouldn't say they've lost hope, I'd say they've given up. A lot of them have given up. You can only ask so many times, and be turned away so many times, that you don't ask anymore," she said.
"The staff that are working to support them are starting to lose hope as well, but we won't stop advocating."
No detox reopening date
CBC News asked Horizon Health for an interview about addiction services and for a date when the detox centre is expected to reopen. No one was made available and no date was provided.
Rachel Boehm, executive regional director for Addictions and Mental Health, said in a written statement that Horizon remains committed to quality and timely access to care. She said patients in "urgent need" are being directed to detox units in Saint John, Fredericton and Miramichi, with transportation offered when needed.
Boehm said in most cases opioid replacement treatment can be provided in outpatient settings. Horizon also runs an intensive day treatment program in Moncton, and an outpatient clinic.
"We are actively recruiting staff to fill the Moncton detox vacancies and plan to reopen the in-patient detox services at our Moncton location as quickly as possible," she said.
Even when detox was open, Maguire and Daley said wait times for opioid addiction were long. They said most of the beds are dedicated to patients detoxing from alcohol.
A Horizon spokesperson did not answer a question asking how many beds were regularly used for opioid replacement treatment.
CBC News also asked for an interview with New Brunswick Health Minister Bruce Fitch. He was not made available.
In a written statement, spokesperson Clarissa Anderson said the need for mental health and addictions services is high in Moncton and across the province. She said a five-year plan is being implemented, focused on community safety, harm reduction, increasing access to treatment and services, and prevention.
Anderson said improving services is also a key part of the provincial health plan.
"Work is underway to increase the number of full-time equivalent (FTE) positions in Addiction and Mental Health Services sites across the province, to both improve access to services and help address the increased demand for care," she wrote in an email.
'Like a revolving door'
On Lester Avenue in Moncton's downtown, two dozen people gather outside an old house that's been converted into a residential rehabilitation program. They're exchanging hugs, laughs and stories.
Cal Maskery makes his way throughout the group, which is waiting for a meeting to start. Maskery, who founded Harvest House, has worked in shelters for decades.
He now operates the Shekinah Glory Outreach Centre, a faith-based program for people who need transitional housing, and want to overcome addiction. In order to take part, people have to be completely sober.
Maskery said the addiction crisis is visibly worse in the city, and with the in-patient detox centre closed, it's more challenging than ever for people to start their recovery.
"We'd say 'you come to us right from detox,' because they can go out and get tangled up again. Now without detox it has been harder," he said.
Maskery said people coming out of detox also didn't always get the help they needed. Many went back to the streets, surrounded by others in addiction, and would start using again.
"It's like a revolving door. And I've talked to them at detox. They've been discouraged because they help someone for five to seven days, they're back out and they're calling back a week later. People need ongoing support," he said.
Nowhere to turn
Back at Ensemble, staff are continuing to hand out supplies as they prepare to open the supervised injection site. The space is only open weekdays, but they hope to eventually expand to weekends.
While Keisha Daley hands out safe supplies to those who are still using, she is also working on her own recovery, and trying to find a way out of the shelter where she lives. She said what people like her really need are long-term treatment options and housing.
"You don't want to be in that addiction but you fall into it. And it's not something that you want to be a part of, but you end up being a part of it. And some people don't understand that," she said.
Daley is trying to recover through methadone, a drug used to treat opioid addiction. She goes once a day to a clinic to get a medicated drink. For people living on the street, she said it can be difficult to keep track of time. If you miss a few appointments, your treatment stops.
"It's been a year. I'm getting there, but it's slow progress," she said.
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