The Last Door
A program for recovering drug addicts shuns the harm reduction model
A group of 30 men sits on battered chairs in a circle in a large room in the back of an old house on a quiet street in New Westminster. It’s a very tough looking group. There are men with big boots and tattoos, and some with grizzled beards and scars. Some are well dressed. They are of all ages, but they all have one thing in common—each man is a serious drug addict, and each one has somehow found a way to get completely clean from drugs.
This is the daily group session at the Last Door, a facility so named because if you fail at recovery here you are probably going to die. The Last Door Recovery Centre is an addict’s last chance, and the successful model they have built for addicts seeking recovery should be a blueprint for every other drug program in Canada, because whatever they are doing at the Last Door really seems to work.
“I lost everything,” says one man with a broken nose of a boxer. “I should be dead,” says another in a leather jacket. “My son killed himself,” says a third, just out of jail. “I used to rob people at gunpoint,” says another. The stories are horrifying, of pain and torture and personal failure, and all are true. Honesty is the only policy allowed here.
Walking through the front door at the Last Door is an extraordinary experience. The electricity in the air is tangible. Visitors are immediately greeted with huge smiles and often a hug. Everyone offers an introduction and holds out a hand. It’s like a Sunday morning church meeting; you half expect group singing to spontaneously break out. These are seriously happy people.
“Ya want a tour or what? Hey, lemme show ya what we did to the upstairs. You won’t believe what this place used to look like and what it looks like now.”
Dave Pavlus is director of the Last Door. Along with wife Louise Cooksey, he founded the Door over two decades ago. Pavlus does not look like the kind of person you’d want to meet in a back alley. Although he has chopped off his waist length hair and wears glasses (“I’m 50 now, I’m getting’ old”), with his big boots and tough demeanour Pavlus looks like a biker dude who escaped from a maximum security prison. He is, in fact, a former serious drug addict himself. In his prime, he says, there wasn’t anything he wouldn’t drink, snort or inject.
“In my day I was what ya call a junkyard dog,” says the ever-affable Pavlus, leading his way to the top floor of the huge Victorian house that the Door’s residents call home. “If you could get stoned on it, you bet I’d do it. Why, I’d swallow shit off the sidewalk if I thought I’d get high.”
There are 20 men in the main house on three floors, bunking two to a room. A newbie is always paired with another client who has been at the Door for a while. Beds are properly made, rooms are tidy, and the entire house has been remodeled, mostly with donations and volunteer labour from alumni. The Door has an awful lot of alumni. Apparently there are a lot of drug addicts in Vancouver. The lucky ones are those who stumble across the Door.
“Personally I think anyone can make it,” says Pavlus. “We’ve had people on death’s door come here and they recovered, police officers, fire fighters, and crown counsel. Our whole philosophy is based on abstinence, the 12 Steps practice, and we really emphasize that. We don’t concentrate on drugs, we concentrate on addictions and that includes drugs, gambling, sex and smoking.”
When it was first founded, The Last Door accepted men who had been tossed out of every other recovery program in the Lower Mainland; hence the name. What makes the Door different is its strict emphasis on building a strong sense of community. The Door is not just a job for Pavlus or Cooksey; it’s an extended family that has grown and been very successful over the years because of their values.
“What’s lacking in addicts’ lives is any spiritual sense. They’re numb, they don’t feel any emotion,” says Pavlus. “Drugs will do that to you. We teach people to get their feelings back. Everything we do here is based on building a sense of family, of community. You don’t come here unless you are serious about changing your life. If you want to keep on partying, go some place else. We don’t punish people, we don’t do medication. We welcome people with open arms and nourish them. It’s a giant family. Hey, we even do all our own shopping!”
The Door’s 60 beds are self-funded from a wide variety of sources. Staff is mostly comprised of volunteers, recovered addicts still living on the premises. There is no set fee structure; 20 of the beds are “no fee for service,” free to people on welfare. Addicts with private or union insurance pay up to $5,000 per month, in sharp contrast to private clinics that charge up to $20,000 per month. There is usually a two-month waiting period, but no one in need is ever turned away.
To pay the freight the Door holds fundraising events and enjoys a huge amount of support from alumni. Starting with one house, Pavlus has quietly purchased several nearby apartment buildings and established a Youth Door not far away. What used to be a seedy block of flophouses is now a sparkling row of renovated properties where the graduates live in “aftercare” before moving on to independent living. Neighbours love the changes on the block, says Pavlus, and the cops and city hall are pretty pleased too.
Cooksey runs a women’s support group for the wives and girlfriends of the Door’s male clients; she has a working relationship with another program in New Westminster that accepts female addicts.
“Yeah, there’s a real positive vibe happening here,” says Pavlus. “Housing is just as important as treatment. Environment has a lot to do with recovery. Man, I used to live in the Downtown Eastside, a dump I called The Bomb Crater because that’s what it looked like. I don’t go nowhere near the Downtown Eastside any more. It’s like a funeral down there, a call from the grave.”
Speaking of the Downtown Eastside, Pavlus is not a big fan of “harm reduction.” Even the phrase makes him laugh. “I call harm reduction ‘putting a bandaid on a bullet hole.’ The whole Four Pillars strategy is a joke because the only thing that gets funded is harm reduction. Addiction has become a huge industry. There are all these people who make a good living off it, they are real loud and their voices are all the public ever hears. People in recovery aren’t saying anything about harm reduction in public because anonymity is a big part of the recovery process. I used to scream my head off about the harm in harm reduction, and I got political and sat on panels and all that stuff, but it didn’t work. I decided to ignore all that and simply build a model that really works.”
Another negative aspect of harm reduction, says Pavlus, is that once society accepts that drug addiction is “normal,” then you have a really serious problem. Crack, cocaine, booze, crystal meth, ecstasy, pot and heroin; it’s all available to kids in schools these days. Young men are gunning each other down to make fast money for cars and women, and drugs.
Angus White (clients names have been change to protect their anonymity) knows all about drug abuse. At age 17, he is a successful graduate of the Door’s ‘youth division.’ Two years ago he was heavy into cocaine and methamphetamines and at death’s door. To White, the Last Door “was just like magic.” He wants the world to know there is indeed a recovery model to emulate.
“When I was a kid I was diagnosed with attention deficit disorder,” he says. “I don’t know if that is an excuse or not, but I became a real loner. My parents were divorced when I was nine. I started at 10, smoking pot, then I got into ecstasy and meth. It just escalates on you. I stole from everyone. The drugs become an absolute necessity.”
White was tricked into a meeting with his parents and school principal and offered a choice; treatment or the street, a one-year program in Calgary or three months at the Last Door. He chose the Door because it was shorter and he could get back to drugs quicker.
“The moment I walked into the Last Door I knew there was something magical there,” he swears. “The atmosphere was overwhelming. I felt unconditional love. It took me about three weeks to get really started in the program, because you really have to want to be clean to recover, and that wasn’t my feeling when I first got there. I did it for my family, and then I learned to do it for myself.”
White spent eight months in care, learning to take care of himself and responsibility for running the house and his own life, supported by other residents and especially alumni who are constantly available for advice.
“When I started doing drugs, I stopped growing up. I didn’t mature. That’s what happens with drug addiction,” he says. “You grow physically but not spiritually. The Last Door gave me the opportunity to be part of a family. I never thought I would ever be part of anything again.”
White hasn’t used any drugs for 18 months and when not in school he volunteers at the Door every Thursday night.
“The Door is a simple program for very complex people. It doesn’t even seem like treatment. It’s like school, you need to write up the 12 Steps, based on the Narcotics Anonymous system. First, you surrender; you need to know you can stop, you find out where you went wrong, you accept yourself for what you are. You have to be totally honest. Honesty is the key to everything.”
As for harm reduction, White doesn’t understand the concept. “Either you use drugs or you don’t. If you use drugs, they can take over your life. I want to be a physiotherapist and I can’t do that while I am stoned. The Last Door outlines the rules but they are quite clear that the residents have to make change happen. You can only pass the joint so many times, make so many excuses. When you are stoned you don’t know how good life can be, you can’t see the opportunities.”
According to Anna Jones, Executive Director at DEYAS (Downtown Eastside Youth Activities Society), the picture painted by the Last Door isn’t quite as black and white as it appears to be. Harm reduction plays a big part in the overall recovery process, she says, and circumstances are different for everyone involved with drugs. DEYAS, whose staff hand out clean needles to addicts on the street and condoms to sex trade workers in order to stop the spread of disease, is definitely in favour of harm reduction.
“People on the street, they usually don’t want to be there,” she says. “Circumstances led them there. A lot of agencies they turn to for help have barriers. For kids, that can mean things like no smoking, no sex, no condoms given out. I think the Last Door is an awesome program, but I have a problem with any agency that says ‘we only help people who want to change.’ Some people aren’t ready to change, so what do you do with them? A lot of people are dying because of all the barriers. If they aren’t ready to be helped today, we have to make sure they can access help when they decide they want it.”
As for taking people off the street who are really sick and can’t help themselves, Jones is not against the idea, but not if it is against the addict’s will. However, if it was her own16-year old daughter that was addicted to heroin and going to die, she has a different opinion. “I’d lock her to a post and not let her go.”
Former client Ron Smith, 53, says that when you get older, “the highs don’t get high and the lows get much lower.”
“Eventually depression kicks in and then sickness. The only answer in the long run is recovery. What that really means is complete abstinence. You can’t use anymore, or you’re dead, ” says the alumni and president of the Door’s board of directors.
Smith was a dashing young firefighter in 1988 when he first discovered cocaine. He did a few lines and was immediately hooked. “I thought: ‘Wow, where has this been all my life?’ I fell in love with coke. It answered all my questions of self-esteem, it made me bigger and badder. I was the first to party and the last to leave. Coke took total control of my life.”
Over the course of a decade he lost two marriages, his investments and eventually his job. One day a senior member of the fire department gave him an ultimatum; treatment or dismissal. He spent 28 days in a treatment centre in Maple Ridge and snorted coke in the parking lot the instant he got out. He managed another 18 months on the job before being offered a last chance at the Last Door. He snorted an entire ounce the day before checking in.
“I should have been dead. I tested positive for drugs every day for 17 straight days at The Door, and they threw me out. That’s how much dope I had in my system,” he says. “I got a doctor to test me again and I got one final last chance. I spent four months at the Door and turned my life totally around. I’ve been clean 11 years now, and I still volunteer two or three times a week. The energy in the building, you walk in the front door and you can just feel it. For me, it’s all about giving back, paying my debts to society, to my union who supported me, and helping others who are in the same mess I was in.”
According to Smith, still a firefighter but now in upper management, the Door has an amazingly high success rate, as much as 80 to 95 per cent of clients, depending on how you measure results. Failure usually means death from an overdose. He says the success rate for other treatment programs, such as simple “cold turkey” self-treatment, can be as low as one per cent. The harm reduction model, says Smith, is the biggest failure of all, nothing more than political correctness, a quick fix by vote-seeking politicians that will never work. All levels of government are throwing money at the theory, hoping the whole drug crisis will go away. Instead, he says the opposite is happening.
“Chronic users, like in the Downtown Eastside, need to be taken off the street. There’s no chance they can stop by themselves and they badly need help,” he says. “We have all become so desensitized to addiction, we are all so cynical and jaded we actually believe that nothing can be done, but these are people’s lives that are being completely thrown away. Addiction is a very sad business, and the general public just doesn’t seem to want to know anymore.”
This year marks the 25th anniversary of the founding of the Last Door (www.lastdoor.org) and several events are planned to raise awareness of its programs and to acquire funds for more expansion. A black tie ball at the Pan Pacific Hotel is coming up in May. A 25th anniversary alumni reunion will be held soon.
Alumni are a huge reason for the success of the Last Door, says founder Pavlus. Not only do they act as mentors and role models for the younger clients who enter treatment, they are the non-profit society’s biggest supporters.
“Hey, we get hundreds of alumni out for dances, and you’ll see maybe a thousand people come out for a baseball game,” says Pavlus. “We buy entire sections at the Giants and Canucks hockey games. What we do here is simple; we get people off drugs and off welfare. We get ‘em straight and we get ‘em jobs and housing. The whole thing is ya gotta have heart, love ‘em and treat ‘em like people. We give people a second chance at life. After all, this is the last door.”