Understanding harm reduction: River Stone Recovery Centre

The River Stone Recovery Centre on King Street in downtown Fredericton, N.B. is pictured in this photograph. (Mary Allen/AQ)

An empty shopping cart with snowy red mittens teeters on the edge of the ramp leading to River Stone Recovery Centre on King Street in downtown Fredericton, New Brunswick. Inside, people crowd the halls, leaning against walls and sitting on stairs. Plastic bags full of belongings are tucked under their feet. The centre was closed from noon to 1 p.m. They are waiting for the doors to open.

The centre is a healthcare clinic treating people living with opiate and stimulant use disorders. The pilot program is funded by Health Canada’s Substance Use and Addictions Program, developing best practices for injectable opiate agonist therapy (iOAT).

Three times a day, iOAT participants can come to River Stone to inject prescribed opiates under the supervision of healthcare workers.

The program is one response to the opioid crisis and focuses on harm reduction. According to research by the River Stone Recovery Centre, for many as 20 per cent of people, oral OAT medications, like methadone, do not work. This is an alternative solution.

Dr. Sara Davidson, from the Downtown Community Health Centre, and Dan Pike, owner of the Medicine Shoppe Pharmacy, applied for the funding to open River Stone Recovery Centre.

Davidson went to medical school as a mature student and graduated and completed her residency over a span of ten years. She is now a physician, using her new title to amplify her voice.

Davidson has become a leader in addressing the homelessness crisis in Fredericton. Support and harm reduction services are at the centre of her efforts. Programs like iOAT play an integral role in the holistic healing process addressing homelessness.

Riverstone has created a space where people feel accepted and valued within a medical space.

“They get to feel they matter, because they do. We need to make more space for people who are living unseen,” he said.

Davidson wrote an article in the Journal of New Brunswick Studies debunking myths surrounding homelessness, demonstrating the cost of “keeping people homeless.”

She said some common myths about homelessness are that it is a moral failing, that there are plenty of services for homeless people, homeless people are drug addicts and “some people just don’t want to be housed.” 

“People just need the housing,” said Davidson. “They don’t need to get prepared for housing, they don’t need to be ready for housing, if they have no house, they need housing, period. The only criteria they need to be housed is they don’t have one as far as I’m concerned.”

Davidson said there is a cost for not helping people experiencing homelessness. The John Howard Society demonstrated an 80.8 per cent saving in healthcare costs for one individual. In one year, after receiving supportive housing, $96,000 was saved.

The cost of medical service ranges from $118,750 while unhoused, to $22,750 housed according to the John Howard Society.

She said the money saved does not take 20 years to get back — within a few years, the money is paid back.

“I don’t like injustice, especially when it doesn’t make any sense,” she said. “I’m strongly driven by fairness.”

Davidson says an investment in housing takes the pressure off provincial spending on things like incarceration and health care emergency room visits.

“When you house people and properly support them, you don’t have to incarcerate them and treat them in the [emergency room] nearly as often.”

In Fredericton, there are more than 150 people on the by-names list. Of those, approximately 60 people are categorized as high acuity+, which means they have complex mental health needs intersecting with substance use disorder. 

Davidson says it’s not as simple as handing over the keys, there needs to be an acknowledgement of past trauma, an acknowledgment that these people have been living outside for a long period of time and a level of understanding and support.

Once housed, Davidson says people can relax, but that is also when old problems can come back. On average, people need about three years of ongoing check-ins and support.

Davidson says her ideal situation would be a housing system that was sensitive to people who are on different levels and trajectories of substance abuse.

Along with affordable rentals, there would be a social hangout centre. She said psycho-social support is important.

“It’s to create a bit of an incubator to help people be their best and be supported to then give back,” she said. “That’s the therapy, that’s the medicine that really helps people, through that social engagement that they very often lack.”

Gill Hastings is someone who experienced homelessness first hand. He now helps run The Homie Project with Angela Hopkins, an organization that delivers meals and supplies to the homeless population of Fredericton.

Hastings said he was always transient, working and travelling across the country. He only considered himself homeless for the past ten years. He explains that a mixture of substance abuse issues, bad decisions and problems with law enforcement led to him being unhoused.

“Things combined into the perfect storm, which rendered me homeless,” said Hastings.

Hastings says it was his relationship with Hopkins that helped him out of homelessness. After meeting at a grocery store and connecting through his dog, O’Ryan, Hopkins offered her pet grooming services.

“It wasn’t until a friend of mine showed tremendous kindness and understanding and gave me support that way that I started to recognize that maybe I should start putting some effort back into my own life,” he said.

Hastings nearly missed his appointment, but Hopkins was determined. They developed a close relationship, would talk frequently and walk their dogs through the woods.

Christmas of 2020, Hopkins offered to pay for a hotel room for Hastings and O’Ryan for three nights.

“When I walked into the hotel room on Christmas Eve, she had a gift basket, one for me and one for O’Ryan. It melted my heart — the chip on [my] shoulder was just gone,” said Hastings.

Hastings said while there are support systems in Fredericton, he didn’t find them beneficial.

“They didn’t seem to work for me, for whatever reason.”

Hastings said a lot of services weren’t accessible and he was often let down.

With the growing number of people experiencing homelessness, these services may not be working for others either.

Jason LeJeune is the finance chair for the task force on homelessness. LeJeune was asked to join the task force by former mayor Michael O’Brien, but he also chose to get involved for personal reasons. Isaac’s Way, a restaurant he owned, had rooming-houses above. When it burned down in October 2012, it left 26 people without a home.

LeJeune has helped find the money to fund renovations at the City Motel. By summer 2022, there should be 12 affordable housing units made available.

“The community has come a long way in the past three years,” says LeJeune.

Davidson also wants to restructure the rules for housing. She wants to shift the focus from a person’s ability to abide by sometimes arbitrary rules and instead let the focus be on providing care for vulnerable people in the city.

She worries about those who might get left behind.

The stigmatization and marginalization of people prolongs a problem Fredericton can solve,” said Davidson.

“It’s to still be able to value and be able to see through all of the surfaces to who the people really are underneath, I just feel everyone should have an opportunity to be seen,” she said.

Near the exit doors of Atlantic Superstore, a small man sits hunched on the curb with a Tim Horton’s cup between his feet. He has a baseball cap on, a mask over his nose and mouth and his hands are bare. A woman hands him ten dollars and he looks up.

“Thanks, girl,” he says. “I appreciate it.”