Stéphane hasn’t had to beg for money in three weeks.
“Before, I begged every day,” he said Wednesday from the fourth floor of Montreal’s Old Brewery Mission.
When Stéphane needed money, it was in part to buy alcohol to feed a heavy dependence he said began 15 years ago. Twelve of those years have been spent on and off the streets.
“I’m fed up,” he said. “I think I’m in the right place.”
Between remarks, Stéphane sipped on a beer — one of several that will be given to him daily, in predetermined doses, over the course of his stay at the Old Brewery Mission. Stéphane (who preferred to keep his last name private) is one of a few early participants of an alcohol-management program that officially opened at the shelter on Wednesday. It aims to address the needs of men with chronic alcoholism experiencing homelessness in Montreal.
For people like Stéphane, until now, there seemed to be no realistic avenues to long-term help in the city.
“Historically, emergency shelters have not been able to welcome people who are heavily intoxicated,” said Élaine Polflit, a co-ordinator with the Continuum populations vulnérables et intervention de crise at the CIUSSS du Centre-Sud-de-l’Île-de-Montréal. “Those persons have historically been even more marginalized than people who are already homeless.”
The inability to access existing services has left those with chronic alcoholism in precarious situations, often having to rely heavily on health and emergency services.
“We’ve seen some of the participants in this program coming back to the facility from the hospital because they’d been hit by a car, because they’d fallen down stairs, because they’d gotten into a fight and not even known,” said Old Brewery Mission president and CEO James Hughes. “And that’s the kind of risk they’re facing every day, and that’s the kind of risk we’re going to try to reduce and eliminate through this program … this is really a proactive, early intervention type of program that will hopefully prevent further harm from happening to these people.”
The program isn’t the only one of its kind in Montreal, but this one is unique for being located in an emergency shelter specifically. Funded by the provincial government and managed by the shelter and the local CIUSSS, the program is meant to be a transitional phase to stabilize a person’s health so they are then able to move on to services that weren’t previously realistic options for them.
The goal isn’t necessarily for users to stop consuming alcohol entirely, “but for many, that becomes an avenue that they couldn’t have pictured until present,” Polflit said.
The program provides more realistic help for people with chronic alcoholism for whom strict options such as detox and AA programs do not work, Polflit said. Many of the people they anticipate will join have already tried and failed to get through others.
“We know from the research that there’s a population that their alcohol problem is so severe and so chronic, that there is no way that asking them to go through something mandatory is going to work,” Polflit said.
Stéphane is one of those people.
“Quitting in one shot is too hard,” he said. “I’ve been drinking for 15 years non-stop.”
The program, which comes after a pilot project at the old Royal Victoria Hospital, can accommodate about 30 people at a time and has no fixed duration. When a person begins, they’re consenting to having their alcohol consumption managed by the shelter. Dosage is determined through discussions with the participant and staff and is administered once an hour all day, with the goal of avoiding both withdrawal and intoxication.
“We try to find that sweet spot where the person is comfortable,” Polflit said.
What this does is shift a person’s motivation away from finding ways to consume since the need is already met, said Emilie Fortier, the director of the St-Laurent Campus services at the shelter.
“Here it’s stabilized, it’s secure,” she said. “Slowly, we have people who started playing chess, for example, taking time for themselves, buying themselves electronics, discovering Netflix. Things like that. Things that they didn’t even have any mental or physical space to get to those objectives (before).”
Stéphane said on Wednesday he has projects planned for the future. Though he’s only been in the program for a few weeks, he said he feels like he’s already changed — he’s more social, which he attributed to better sleep, and physically, he feels great.
“I was really messed up. I was 80 years old before starting here,” he said. “Now? I’m 49. I’m my age.”
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