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More substance use clients STARTing to detox at home

Vancouver, BC – Sandy, a health care worker, and her husband Dave, a tradesman, (not their real names) called Vancouver Coastal Health’s START program on New Year’s Day. “We were both addicted to opioids, pawning and losing our possessions to pay for drugs, lying to our families,” says Sandy. “My husband got hooked on opioids nearly a decade ago after being prescribed painkillers for a workplace injury. I started using drugs while I was struggling with depression.”

Since the Substance use Treatment and Response Team (START) launched in August 2016, it has helped 329 people like Sandy and Dave detox at home, and has the capacity to assist even more individuals. 

“The sooner people with substance use problems can get the help they need when they are ready, the better their chances of success. Offering home visits where people addicted to opioids get access to medication treatment right away, makes getting help quick and easy, and saves lives by reducing the risk of overdose,” says Judy Darcy, Minister of Mental Health and Addictions. “There is no one-size-fits-all approach to recovery, and it’s critically important to have a range of options to support people on their journey to recovery.”

Eighty-eight per cent of overdose victims in the Vancouver Coastal Health (VCH) region die in private homes, rooming houses, hotels and other types of residences. They are mothers and fathers, sons and daughters, who in some cases would not or could not go into residential treatment. At-Home detox is one of a range of substance use services in the region to meet the needs of individuals, which also includes outpatient treatment services, drop-in centres, rapid access addictions clinics and residential treatment.

START caters to clients from all walks of life. “Many of our clients are employed and struggling with addiction,” says Mary Marlow, Manager Mental Health and Substance Use, Vancouver Coastal Health. “We’ve had teachers, single mothers with children, construction workers and those with disabilities seek help. For many, residential detox is not an option because of the associated stigma.” 

Sandy and Dave wanted to seek treatment together and he needed to be available to work, so detoxing away from home wasn’t a viable option. “We also felt we would lose our jobs if our employers knew about our drug use, because there’s still so much stigma,” says Sandy. 

START is a two-week program. During the first week, clients are assessed by a nurse and physician and followed with daily home visits. Suboxone is often prescribed for opioid addiction and benzodiazepine for alcohol addiction to assist with withdrawal management. The second week of the program involves stabilizing clients and connecting them to ongoing support. Family physicians take over the prescribing of medication once the individual is stable. Everyone who goes through the START program for opioid addiction is connected to ongoing opioid replacement therapy in order to mitigate the risk of overdose. 

The START program has the capacity to help 400 people per year. It recently began providing services to youth, as long as they have a support person in place to monitor their withdrawal. The program is available to Vancouver residents who are living in, or have access to, stable, substance-free housing. START can help connect clients to short-term transition beds if they require a stable environment to go through the rapid detoxification program. 

START accepts referrals directly from clients or their doctors, and services can begin within 24 hours of making contact with the program. For more information contact START: 604-675-2455 or Vancouver Coastal Health has a range of health care and support services for those struggling with substance use. Like most illnesses, getting early treatment is important. Clients can access all services through Access Central: 1-866-658-1221. 

Sandy and Dave are now 10 months substance-free. “We are so appreciative of what the START team has done for us. Being able to detox at home with my husband and have a support team of doctors and nurses certainly contributed to our success,” says Sandy. “Without START, I’m not sure where we would be today.” 

VCH’s START initiative supports the work of the new Ministry of Mental Health and Addictions established in 2017. As part of the wide range of actions being taken, partners across the health system continue to expand access to life-saving naloxone and opioid addiction medications such as Suboxone and hydromorphone, open more overdose prevention sites, work with Health Canada on approvals to open additional supervised consumption sites and improve the system of substance use services. 

VCH is responsible for the delivery of $3.3 billion in community, hospital and residential care to more than one million people in communities including Richmond, Vancouver, the North Shore, Sunshine Coast, Sea to Sky corridor, Powell River, Bella Bella and Bella Coola.


Carrie Stefanson
Public Affairs Officer,  Vancouver Coastal Health
Office: (604) .708-5338
Cell: (604) 312-1148

SOURCE: More substance use clients STARTing to detox at home ( )
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