Run-of-the-mill rehab doesn't work for sniffers.
At least, it's a tough slog. Treatment experts say most residential drug and alcohol rehabilitation programs aren't long enough and aren't equipped to deal with the damage solvents do to the body, everything from brain damage to kidney failure.
But there is no solvent-specific treatment program for adults in Winnipeg, or anywhere in Canada, for that matter. The closest program tailored specifically to the type of addicts who haunt Winnipeg's downtown is in Thunder Bay, but the age cut-off there is 25, leaving older chronic solvent abusers out of luck.
"I get calls all the time," said Raija Vic, the treatment co-ordinator at Ka-Na-Chi-Hih, the treatment centre in Thunder Bay.
The Main Street Project's 2011 Street Health Report noted there are few programs for people who use sniff. Many treatment centres won't even accept solvent abusers. Other treatment centres, especially for youth, prefer to downplay how many solvent addicts they see because it discourages other addicts from coming in for rehab, fearing the stigma.
Even worse, there's remarkably little research on which treatment does work and why exactly some addicts prefer solvents. Anecdotally, they don't seem to do well in traditional treatment, but no one seems to know why. That speaks to just how marginalized solvent abusers are.
In Winnipeg, the Addictions Foundation of Manitoba and the Behavioural Health Foundation will take anyone with any type of drug or alcohol addiction, but they don't see large numbers of solvent users.
Only about four or five per cent of AFM's clients say they've used solvents in their lifetime. That may be because chronic solvent users, the kind entangled in the most marginal street life, aren't necessarily going to walk through the AFM's doors, even though they are always open.
AFM CEO Yvonne Block agreed chronic adult solvent abusers form a high-needs group and are falling through the cracks. She said ideally, any solvent-abuse program should include targeted outreach that slowly builds relationships with chronic addicts to move them toward detox and rehab. And she said a treatment program would also need to have a high staff-to-client ratio and be longer than the typical 28 days or two months.
Experts, including academic researchers, say it can take much longer for solvent users to undergo initial detox because solvents live on in fat deposits.
The Main Street Project and Health Sciences Centre are the only detoxes in Winnipeg, and stays there are often for only 10 days.
Detox can take weeks, as can the rehabilitation process -- the group therapy and counselling, the life-skills programs.
At Ka-Na-Chi-Hih in Thunder Bay, people can stay in the 12-bed residential program for as long as two years.
Vic, echoing several researchers and scientists, says dealing with basic medical problems is a first priority during detox. That includes problems such as hearing loss, poor eyesight, poor muscle control and neurological damage. It also means getting mental illnesses under control. Many solvent users struggle with simple life skills, such as hygiene and proper eating habits. Solvent abusers can find their tastebuds are badly burned, and they often vomit up most food until their bodies begin to return to normal.
And solvents cause brain damage -- at least, that's the assumption -- that can make it hard for conventional drug-treatment programs that rely on rational thought and communication to work.
Reasoning and impulse control can be damaged, and a solvent abuser's attention span could be too short to last through long therapy sessions. In group therapy, a solvent abuser is sometimes considered the lowest of the low.
Since solvents are available everywhere, even in the butane lighter belonging to the guy sitting next to you or the dryer sheet at the laundromat, it takes repeated reinforcement and tremendous willpower to stay clean.
"It makes memories and time go away," said Margaret Ormond, a nurse practitioner by trade and a staffer at Sunshine House on Logan Avenue. "It makes life tolerable, the day-to-day tolerable."
People need a reason to stop, she said, and it's difficult to find one when the sniffers she knows have lost their children and families, have no decent place to stay, can't get the basic dignities of life like a shower and clean clothes and spend days and years on end killing time, moving from soup line to shelter and back.
"No person is ever beyond recovery," said Lighthouse Mission director Sean Goulet, who has tried to find treatment for some of the regulars at his soup kitchen and outreach programs.
"But it's a long road back."
That means it's doubly important for solvent users to delve into the reasons why they use. For the clients at Ka-Na-Chi-Hih, that's usually years of abuse and neglect, poverty, violence and boredom. Vic said one client began sniffing because his hallucinations would frequently conjure up his dead mother. Sniffing was the only way he could talk to her.