The Prevention Conversation: A Shared Responsibility Project

Phil Goss’s road to recovery started on the highway, in the passenger seat next to a 23-year-old Manitoba pig farmer who offered him a joint.

Goss was 37 or 38, “hopeless and helpless” and at the end of his rope as he tried to kick a heroin habit he started when he was 15. He was hitchhiking from Vancouver, where he’d been living, back to Toronto, where he’s from, when the pig farmer gave him a ride and suggested he smoke the joint.

“I didn’t want to do that, because I was on the highway and I didn’t have a lot of money and I wanted to keep my wits about me somewhat,” Goss recalls years later, sitting in his cozy, cluttered office at Winnipeg’s Main Street Project.

“And I declined, and the conversation went from there to addiction, alcoholism, blah blah blah.”

Suddenly, the pig farmer was telling Goss about his dad, his alcoholism and how he got help at the Alcoholism Foundation of Manitoba — now the Addictions Foundation of Manitoba.

Then he was driving Goss there, and dropping him off at the front doors. He didn’t have Manitoba health insurance, so staff gave him cab fare to get to Main Street Project — a low-barrier shelter with addictions services where he now works as a peer advocate.

“Luck happened for me,” he says.

With help, Goss stopped using. But without drugs, he had nobody: not his family, who were a province away and estranged besides, and not friends — he didn’t know how to talk to people sober, and all his old friends still used.

“Near the end, I got pretty down. Pretty low,” he says. “I’m sure that if I kept on doing what I was doing, I would be dead.”

Goss’s experience isn’t unique. Experts say isolation is a critical barrier to recovery for many with addictions, and some say they want to see more programming to help people deal with it and recovery in general.

“The general society could look at the substance being the problem, but I think often feeling isolated, feeling alone, is such a strong feeling that there could be relapse or a return to old patterns,” says Melissa Piper, the supervisor of the women’s in-house program for the Addictions Foundation of Manitoba.

“Not necessarily the substance being the first reason, but because, as humans, we need attachments, we need social connections, we need relationships.”

‘Constant feeling’ of fear

A long-awaited review of Manitoba’s mental health and addictions services released in May describes a “perfect storm” of poorly co-ordinated, underfunded services in the province that lag behind the rest of the country.

The Virgo report noted that in the past five years, the number of people whose methamphetamine use was noted by emergency room health-care workers rose dramatically, shooting up from about 10 per month in 2013 to 190 per month in 2017.

It called for increased funds for mental health and addictions services, as well as greater crisis supports and collaboration between primary and community-based treatment services.

Goss says he felt those gaps. When he wasn’t using, he had a “constant feeling” of fear, and fear kept him alone.

“You can only be isolated for so long and then you want to get into the action again, and there’s only one way you know how to do it,” he says. “You start drinking or using drugs again.”

For many people who use, the substance they’re using can become a pervasive part of their social groups, Piper says. Trying to quit often means leaving social connections behind.

“We see that in our detox all the time.… Clients will come to detox for their addiction, but they get drawn back to the people outside, right?” says Rick Lees, executive director of Main Street Project.

“They miss their friends.”

And Lees says finding new friends is easier said than done.

“You manage to make the transition out, but now what? How do you create a new community for yourself?” Lees says.

“You’re alienated on both sides: you’re neither a non-user nor a user. You’re a person who’s now in recovery for the rest of your life.”

Michael Ellery, a clinical psychologist who specializes in dealing with addictions, says building new connections is “essential.”

“Connectedness really seems to be the antidote to addiction,” he says.

Filling up the hole

Many treatment programs, such as short-term detox, create isolation intentionally, based on the principle of “changing your playpen, your playmates and your playthings,” Ellery says.

“What that seems to be based on is that it recognizes this need to completely reorganize your social group,” he says. “It can be isolating, at first, because you don’t know how to socialize, necessarily, without your drug of choice.”

Ellery attributes the success of programs such as Alcoholics or Narcotics Anonymous — or non-religious versions like Smart Recovery — not simply to the techniques taught there, but also to the group meeting structure that brings people together.

Goss says he met the woman who turned it around for him at an AA meeting. They later got married, and Goss says his relationship gave him the purpose he needed to leave drugs and alcohol behind for good.

“What are we all looking for? We’re looking to fill up that hole or fix the hole,” he says.

“Basically, it all stems around the same thing, that hole you have to fill up in your heart, somehow.”

‘Hope is a big thing’

To create connectedness, experts say a broad range of community-based resources should be developed, and some of them already exist.

In the past two years, Piper has seen more services along those lines pop up in Winnipeg, including Refuge Recovery — a Buddhism and mindfulness-based program — and Crystal Meth Anonymous, which started last fall. She’s optimistic that momentum will continue.

At Main Street Project, Lees says he’s hoping to foster an increase in social programs that aren’t just structured around therapy, like a women’s spa day spearheaded by a former client earlier this year.

But Goss says there are too many gaps in the system as people move through social services, and Ellery says there aren’t enough resources to fill them.

“In general, addiction and mental health treatment and resources across the country are under-resourced. We have a severe shortage of psychiatrists and psychologists. Manitoba in particular has an especially bad shortage of both,” he says.

“There’s just not enough resources for everybody. It can be difficult sometimes to even access medically supervised detox, for instance.”

He’d also like to see the development of more non-religious treatment groups like Smart Recovery, which he helped get off the ground in Manitoba.

For Goss, offering people struggling with substance abuse a chance to have social success is a way to offer them a crucial element in recovery: hope.

“Hope is a big thing,” Goss says.

“[They’re wondering,] ‘OK, so now I’m sober — what am I going to do now?’ Keep your arms around them and then offer them something to do.”