Vancouver youth losing crucial service with detox closure, advocate says

Directions Youth Services' 24/7 drop-in centre is seen in this photo from the organization's website offers a range of programs for young people. (directionsyouthservices.ca)

The upcoming closure of a detox program in Vancouver that has been supporting youth who use drugs for 30 years will eliminate a vital, trusted service, according to an advocate.

Kali Sedgemore, a Vancouver peer outreach worker, knows first-hand what makes the program run by Directions Youth Services a one-of-a-kind resource for young drug users, particularly those who are street-involved.

“For me, it was the first place where I actually got a connection with staff, with people that understood where I was coming from with drug use and street involvement,” they said.

“It was also a place where I got to eat whatever I wanted for a few days, and also just got a break from the streets. It was nice to just get away for a bit.”

The program is one of a range of services offered by Directions Youth Services, including a drop-in centre, harm reduction supplies, an emergency shelter, a safe house, a daycare, and education and arts programs.

Sedgemore says the organization has built up a reputation over decades among vulnerable youth who don’t trust institutions or professionals, and many learn of the organization’s services through word-of mouth.

“The thing about this detox is that you hear good things about it because the people working there are people with lived-experience,” they said.

“It's people who either have been thorough the detox or someone that's also used drugs and knows what your life is like. It's not a medical-based model that has nurses and stuff like that.”

The program’s website describes it as a “social detox in a home-like environment,” and it’s geared toward those who don’t need 24-hour medical supervision. Intake is available 24 hours a day, 365 days a year. It is designed to be low-barrier and non-judgmental.

Nurse practitioners visit the site, and a clinical counsellor with expertise in mental health and substance use is also available. But the non-medical supports like the relationships that are built with staff and other youth, access to laundry facilities, home-cooked comfort food, and a safe place to sleep are what Sedgemore says make a real difference.

“Having that social connection is very important. Having a detox model that's like Directions is so important because it does bring you connections to community. It feels like a home almost. If you want grilled cheese, you can eat grilled cheese for five days,” they explained.

“Actually having someone there that listens to you, actually meets you where you're at instead of someone being like, ‘You should go to treatment’ … It's kind of rare and hard to find.”

And this is what they worry won’t be replaced with the new services Vancouver Coastal Health (VCH) is promising.

The June 3 closure was announced in a joint letter last week from VCH and Family Services of Greater Vancouver (the organization that operates Directions Youth Services).

“As a result of a comprehensive needs-based assessment and consultation with youth and families, along with new guidelines and practices, VCH will be redesigning withdrawal management services for youth to best serve clients’ needs and to provide more options for care,” it read.

“VCH will move toward a flexible and responsive withdrawal management model that will greatly increase the number of youth who can access these important services. This model will include increased access to home and community detox with medical supports, as well as comprehensive, long-term services. “

The letter also promised a “smooth transition” to these new services.

Sedgemore says the mention of home-based options is concerning when it comes to youth who are unhoused or who live with abusive families. They also worry replacement services will be overly focused on getting young people into residential treatment programs instead of responding to what young people say they need.

“I think the big thing is just that we need to understand the fact that youth use drugs. As adults, we think we know what's best for youth. People need to not try to fix them, they need to just listen to them.”

In a statement, Vancouver Coastal Health says Directions' social detox model "doesn’t align with current guidelines and best practices around opioid use disorder from the Ministry of Health and the BC Centre on Substance Use."

As for what other services will replace it, the health authority said they will be creating a new Downtown Eastside youth outreach team, and a new two-bed site for youth detox. For youth that are unhoused, Vancouver Coastal Health says it will " work to secure a caregiver support home space." A date for when these services will be up and running was not provided. 

"VCH is committed to working with our current youth withdrawal management service providers to ensure that youth continue to have withdrawal management supports throughout this transition, and expect no gaps in service," the statement concluded. . 

The closure comes as B.C. continues to see record numbers of deaths from toxic drugs, with 2,224 lives lost in 2021. According to the BC Coroners Service, 29 of those deaths were among those under the age of 19, and 325 were among those between 19 and 29 years old – the highest numbers ever recorded for those age groups.

An online petition to keep the detox open has gathered more than 2,000 signatures.