Home sick

Despite millions in government funding, addiction recovery homes in Vancouver operate without clear definitions of success while Welcome Home, a private abstinence-based facility in Surrey, says it measures success in sobriety

The face of recovery. Bright. Smiling. Hopeful.

Nick Runowski, a handsome 28-year-old with blue eyes and matching blazer, can't help but smile. "I have my life back. I feel feelings. I have emotions. I have my family back in my life. I have mentorship, fellowship. I'm probably living a better life than 90 per cent of people out there."

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Runowski took his first drink at 13. Adding cocaine and OxyContin to the mix, he graduated from user to dealer. In Vancouver's Downtown Eastside, he dealt drugs to feed his addictions. His life was dark, his future bleak. Until Oct. 15, 2009, when he walked into Welcome Home, an abstinence-based residential recovery home straddling the King George Highway in Surrey.

He's been clean and sober ever since.

Last fiscal year, the provincial government spent $1.3 billion on mental health and addictions services. In this era of harm reduction, high-profile initiatives (the Insite supervised injection site, the methadone maintenance program) seek to mitigate the effects of drug abuse (disease transmission, drug-related crime) while the concept of abstinence-based treatment fades from public consciousness.

Meanwhile, the Ministry of Health, through Vancouver Coastal Health, helps bankroll five addiction recovery homes in Vancouver. The homes operate in a bureaucratic nebula with limited oversight, relative mandates and anecdotal evidence of success. And all five homes embrace varying degrees of harm reduction, where addicts may continue using drugs while in residence.

Conversely, Welcome Home's strict abstinence-based approach sets clear guidelines: no drugs, no alcohol, no exceptions. Success is measured in sobriety. Among Vancouver's government-funded recovery homes, there's nothing like Welcome Home.

Back at the Welcome Home cafeteria in Surrey, Nick Runowski shakes his head and reflects on his new life without drugs and alcohol. "It was very tough for the first few months," says Runowski, who was born in Vancouver but raised in Surrey. "This is not just a recovery house, it's a life-skills academy."

Founded in 2009 by millionaire businessman John Volken, former owner of United Furniture Warehouse, the facility accommodates 22 recovering addicts (20 men, two women) who live in five houses on King George Highway near 72nd Avenue. They work across the street at Welcome Home's Costco-style general merchandise store.

Except for a $387 registration fee, the program is free, funded by revenue from the store and The John Volken Foundation. Welcome Home has never applied for government funding.

Bound by strict protocol, program participants (known as students) must remain on site. Furlough passes are earned. Contact with the outside world--phone, Internet--is strictly regulated. There are no drug counsellors at Welcome Home. Policy springs from a non-profit board of directors comprised of businesspeople, physicians and others. Students rely on each other for therapy. Peer-to-peer sessions explore the roots of addiction--past trauma, insecurity, egotism--and foster friendships based on mutual respect and reliance. Anyone caught drinking or doing drugs is expelled from the program.

According to Runowski, there's no other way. "Addicts are the greatest manipulators. That's the nature of the beast. If it's provided, than they'll use it. But it doesn't mean they're going to get any foresight or help."

Abstinence and Vancouver. Those two words rarely conjoin.

"We are the closest to it," says Brenda Plant, executive director of Turning Point, a large, leafy 22-bed recovery house at Cambie and 13th Avenue.

She's right. While Turning Point allows clients to use drugs such as Valium, OxyContin and morphine, unlike Vancouver's other four government-funded recovery homes, it does not allow methadone. (Note: Lax regulation and oversight plague the methadone program, which does not include mandatory drug treatment or counselling.)

According to Plant, the province provides less than 10 per cent of Turning Point's budget, although most clients draw some form of income assistance. Every year, an official from Vancouver Coastal Health reviews and renews Turning Point's contract. However, the "review" seems incomplete.

Like other recovery homes, Turning Point struggles to maintain contact with clients after they complete their minimum three-month residential stint. According to Plant, she successfully tracks roughly half of Turning Point's former clients. Of that half, she says, 85 per cent are clean and sober one year after entering the program. But that figure is based on "self reporting" from recovering addicts. "So we're absolutely taking it at their word," Plant says.

Subsequently, during yearly contract discussions with Vancouver Coastal Health, Plant does not supply success rates. Due to the changing nature of addictions recovery, including the popularity of harm reduction, uniformed definitions of success don't exist. "In the old days, success was measured by three months after graduation, you're still sober," says Plant. "Because we understand that lapses and relapses are part of the recovery process, that's not a great indicator anymore."

If you think the process seems flaky, you're not alone. Plant is frustrated with a lack of accountability in the recovery industry. "Give us benchmarks or help us set benchmarks or outcomes," she says. "We are talking about people lives. We are talking about the most vulnerable part of our population. God, somebody hold us accountable--because the clients can't."

Plant also worries about unlicensed facilities throughout the Lower Mainland that receive no government money. A recent story in the Surrey Now newspaper spotlighted poorly managed homes in Surrey where addicts receive a bed, and little else, while home operators make big money. "And there's no board or authority figure holding them accountable for what kind of programming they're doing."

The Central City Lodge is a 22-bed recovery house at 415 West Pender in the heart of Vancouver's drug-infested Downtown Eastside. It's a 90-day residential program. Harm reduction rules. Clients may use methadone and other prescription drugs.

Unlike Turning Point, which receives a minimal amount of government funding, Central City is basically owned by taxpayers. The province supplies 94 per cent of the Central City budget.

So how's it going?

That depends on your perspective. According to manager Barbara Keith, Central City offers stability to addicts and helps them integrate back into society. But tracking addicts, who've only spent three months in residence, is challenging. While Central City includes voluntary aftercare, many former clients fall off the radar. "We don't do follow-up, in that we go out and track people down and find out how they're doing."

Moreover, according to Keith, while in the program, clients split time in residence and on the street. "They're in programs, in group, in the morning. But they have the afternoon free to go to the community."

But that's a pretty rough neighbourhood. When they leave the facility, how do you know they're not doing drugs?

"They're not in jail, here."

The Courier contacted all five government-funded recovery homes in Vancouver including Together We Can, a recovery home on Kingsway and the Salvation Army's Homestead, a women-only 24-bed house at Oak and 57th. Only New Dawn, an East Side recovery home owned by the Chrysalis Society, refused to cooperate for this story.

Jennifer Canning, executive director at Homestead, acknowledges the need for standards and success rates. According to Canning, she's on the case. "We're currently working out a plan of how we quantify if a woman has been successful, with the understanding that success for every women is going to be different."

So what's the province say about all of this? How do provincial officials, who dump millions each year into the recovery industry, gauge success? And what about comments from Brenda Plant and others, who complain about a lack of accountability in the recovery industry?

Despite repeated interview requests, Mike de Jong, B.C.'s Minister of Health, refused to comment on this story. David Ostrow, CEO of Vancouver Coastal Health, also refused comment. However, addiction experts have raised concerns. According to an August 2010 article in B.C. Business magazine, Benedikt Fischer, interim director of SFU's Centre for Applied Research in Mental Health and Addiction, is baffled at the province's approach to addictions recovery. "In B.C. we're not terribly good at measuring the impact of any of the programs," said Fischer. "I have no idea how [health ministry bureaucrats] make policy decisions when they have no information."

Meanwhile, back at Welcome Home in Surrey, things are less fuzzy.

"Places like this, total abstinence, help people get a life, become the best they can be," says founder John Volken. "What good are you to society, or yourself mainly, if you're an addict?"

Born in Germany, Volken arrived in Canada in 1960. He speaks in soft tones with a slight German accent, and despite a neatly cropped grey beard, looks much younger than his 70 years. When asked about his dramatic shift from furniture to addictions recovery, Volken points to his Christian faith and the responsibility of wealthy people. "Some guys put their money in art or other things, I put my money in this."

According to Volken and others who promote abstinence-based recovery, there are several problems with most recovery homes in British Columbia. For starters, the length of commitment, typically three months, is far too short. Addicts require more time in residence to heal and grow. Welcome Home, for example, requires a minimum two-year commitment. "Short-term programs for drug addicts," says Volken, "simply don't work."

But that's easy for Volken to say--he's a millionaire whose deep pockets help pay for two-year commitments. Considering the current state of government-funded addictions treatment, is Volken's model, based on similar facilities in Europe, transferable? Could taxpayers help fund Welcome Home-style facilities around B.C.?

Maybe, maybe not. But according to Volken, at the very least, existing recovery homes could incorporate Welcome Home principles (abstinence, heavy emphasis on personal responsibility) while millions spent on harm reduction experiments (the supervised injection site) help pay the bills. Volken's a strong critic of harm reduction philosophy. "Those who really know about addiction, those who want to free themselves from addiction, are against this harm reduction."

Since 2009, hundreds have entered Welcome Home in Surrey and a sister facility in Seattle, which is also funded by Volken's foundation. The majority have been expelled or left voluntarily before graduation. Like other recovery homes, Welcome Home struggles to track former clients. But despite the high dropout rate (more than 50 per cent), Volken says the abstinence-based approach benefits anyone who enters the program. "We leave a footprint on all who come here. Even if they're just here for a couple of weeks. They see something healthy, something good." Now more than two years in, the program is beginning to produce graduates--a combined 25 from both facilities so far.

Whatever you're thoughts on abstinence-based recovery, there's no denying its transformative impact on Nick Runowski. He'll be two years sober on Oct. 15. He's been given a second chance on life. You can see it in his eyes. "I thank God, I look forward to each day. I've changed completely and I'm still growing. If you told me two years ago I'd be where I am today, I would have never believed it."

mhasiuk@vancourier.com

Twitter: @MarkHasiuk

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