"You've just got to be prepared to lose clients to death. And I'm talking about young women 40 years old, young men in their late 20s and so, over the years there's been a few of those. It is quite heartbreaking."
Rama says alcohol remains their biggest hurdle, and P is in second place. Synthetic cannabis has also been trickling in and is believed to have killed a 22-year-old last month.
Over the past year, 375 people have been referred for residential detox, spending usually seven to 14 days at the centre.
"We go from 18. Our oldest this year was 87. So there's no discrimination between male, female or ages."
Rama says she wouldn't know how many clients might be gang members, as no patches are allowed to be worn.
She knows of one addict battling alcoholism, who first came to the centre in his 20s, and came back a further 56 times.
He's now in his 70s and has been sober for eight years now.
Arecovering alcoholic in detox for a third time told NZH Focus he feels welcome at the centre and is optimistic about the future.
"Everyone's different so you have to follow your own journey. I've been around for 12 years in recovery so I know the path to take and how to do it. It's just a matter of doing it."
Rama says detox is effective while the person is in the centre.
"But you've gotta take from here out to the community, where on every corner you've got somewhere you can buy something. So it's like teaching them about how to live in the community again."
She says the five extra beds they're getting as part of a major partly Government funded redevelopment of the Auckland City Mission, still doesn't meet the city's big demand.
The Government announced $27 million for the project last August. The Mission has to come up with the $48 million shortfall.