Wet shelters are 'modernized health care' and important, say big city shelters

Pat Carlson has pushed for a wet shelter in New Brunswick for more than 15 years, and as the number of people experiencing homelessness rises, so too do the calls for such a shelter.

A wet shelter accepts people who are under the influence of drugs or alcohol and offers a supervised space to use or consume them.

Carlson advocated for such a shelter during her time as executive director of the Fredericton shelter. She was met with resistance, but more than 15 years later she still believes it's a good idea that could help people struggling with addiction.

"I think people are just so uneducated. All they see is the guy drunk on the corner downtown," she said. "But they're not going home and finding out how hearts are broken and families are torn apart."

"People who have lived with an alcoholic or a drug addict in their homes are more open to trying anything that might work. But for most of the population, they're just seen as troublesome, and all they need to do is stop."

Debby Warren, executive director of Ensemble Moncton, said with four shelters open in her city it's time for one to be wet and include an overdose prevention site.

WATCH | Many struggling with mental health and addiction are still sleeping outside: 

A new emergency shelter opened in Moncton before Christmas but many people continue to sleep outside, Warren said, because they have been banned from shelters for using drugs or alcohol, or for the behaviours that come with it.

Shepherds of Good Hope in Ottawa is a three-storey, 200-bed downtown shelter that's been operating as a wet shelter for more than 20 years.

"Anyone can come," said Steven Parker, the senior manager of supportive housing, even if they are "heavily under the influence" of drugs or alcohol."

The shelter offers beds for men and women, and has doctors, nurses and personal support workers to care for people who are drunk or high.

Parker said it's not just the services offered that make a shelter wet, it's also the philosophy and the acceptance that come with it.

"We provide services to people who often are in the greatest need of assistance and so we don't want to bar … [or] exclude people for the very reasons that they need these types of services," Parker said.

The most common reasons people need help are addictions, mental health problems and trauma.

"So if you're going to bar people from the services, you're kind of operating services that you need them to mould to fit, as opposed to the other way around. It's our obligation to design supports for what they need and not what we need."

Good results for individuals, community

Shepherds of Good Hope is supported by the City of Ottawa, Parker said, because it benefits the entire community.

A unique partnership with hospitals and paramedics allows intoxicated people picked up in the downtown who are known to be homeless to be taken to the shelter rather than an over-burdened emergency room.

"It saves a lot of money on the system and a lot of resources for the whole sector," said Parker.

While people can use substances in the shelter, it is not a drop in centre or "warehouse," he stressed. Residents are expected to work with staff to get to the root of their issues and find ways to move forward.

"It can be tough for people to comprehend the level of substance use we see," he said. "The minute they wake up, they're finding whatever they can to consume to the point of blackout and passing out in the middle of the streets, urinating themselves, getting beaten up and robbed."

Success is defined differently for every individual, said Parker.

"Sometimes it's people that have not had a place to call home for 20 years that are now just comfortable enough to take their boots off at bed. Because they're not worried that they're going to get stolen."

For others, success is regaining dignity and reconnecting with their families.

There is also success for the larger community, Parker said, with fewer people panhandling or passing out in parks.

"And then we're not using as much of our city resources responding to all these 911 calls, not seeing all of these problematic behaviours."

Montreal shelter tries managed alcohol program

The Old Mission Brewery in Montreal isn't a wet shelter, but CEO James Hughes does see promise in a new managed alcohol program introduced eight months ago.

Hughes, a deputy minister in New Brunswick's Department of Social Development between 2008 and 2011, said "every urban centre" has people who are difficult to serve because of mental health challenges and addictions.

"So what do you do? What you don't do is give up and and introducing this program … has been a real lifesaver for many."

The managed alcohol program is open to 10 men, who are prescribed a specific dose of alcohol at specific intervals — usually one beer every hour.

Program to become permanent

Hughes said the program is allowing people to begin to have conversations about how to rebuild their lives.

"And that's sometimes a very hard conversation to have. But it's one we can have with people who no longer drink 12 beers in an hour but drink 12 beers over 12 hours. And that's the magic of these programs is that it really gets that drinking under control and in some cases even reduces the amount of drinking."

Hughes encourages New Brunswick's government to consider a pilot project in Moncton that could expand to other cities  and include other substances.

In Fredericton, Dr. Sara Davidson offers an opioid replacement program based on the same harm reduction principle  and is seeing good results.

Hughes expects the managed alcohol program, which he calls "a feature of a modernized health-care system," will become permanent and will be completely funded by the Quebec government.

Social safety net 'full of cracks'

Parker said there is a need for social services and health departments to work together with charities. Medical professionals have to be part of the solution for people struggling on the street.

"A lot of us are being asked to support and solve some of society's most complex problems," he said. "And yet I think there's this traditional expectation — like do it on a volunteer basis with very little resources."

Hughes agreed and said it's time governments work with communities to serve everyone.

"The social safety net in New Brunswick, in Quebec and everywhere else is full of cracks. And it's our obligation, our moral obligation as citizens, as voters, as politicians … to try to patch all of those holes and make sure everyone can be supported to maximise and optimize their journey on this earth."

After more than 15 years of pushing for a wet shelter, Carlson hopes change is finally afoot.

"You need the police force behind you, you need someone in the medical profession and you need a politician that will carry this as a torch."