Friday, September 27, 2013

Addicts Don't Need InSite, They Need Support

This piece in the Huffington Post, written by Kathryn Marshall, lawyer, columnist and political commentator, was sent to us by Sean Heaney who runs a wonderful and dedicated small recovery centre on the east side of town.

Last week's controversy over Health Canada's funding of a program to give heroin to select addicts is like déjà vu. It's an awful lot like the conflicts the federal government has had with similar drug programs over the years. The Insite supervised injection clinic in Vancouver's renowned Downtown Eastside is the most famous example, where addicts can go to inject heroin under the supervision of nurses. Centres likes these are sometimes called "safe injection" sites, which is truly an oxymoron considering that these harmful drugs are anything but safe.

There has long been a debate raging in Canada over how best to help people who are addicted to dangerous, illegal drugs. It's been played out in the court rooms and among politicians and policy makers on repeat, yet we don't seem to be getting closer to actually helping addicts in the Downtown Eastside recover.

All it takes is one trip over to the Downtown Eastside and you can see for yourself that centres like Insite are doing little to get the addicts off the street and into places where they can get off drugs and get their lives on track. Arguably, places like Insite are actually making addictions worse by enabling the drug use and sending the message that it's "okay" to use drugs, so long as it's done "safely."

The Downtown Eastside is an extreme example that represents only a small part of the problem. Drug and alcohol addiction are serious problems in communities across the country that often exist in privacy behind closed doors, not in full view on street corners.

Marshall Smith is an addiction expert who knows first-hand what it's like to be stuck in the depths of an addiction. Ten years ago he was a successful political staffer with a bright career ahead of him. Then someone offered him some cocaine, and he was instantly hooked. His life derailed and he spent years living as a homeless addict, including in the Downtown Eastside. Smith recovered, and is now the Manager of Corporate Development and Community Relations for Cedars at Cobble Hill, an addiction treatment center on Vancouver Island.

According to Smith, in order to craft a successful strategy to deal with addiction, government policy makers need to be talking to people who have actually beat their addictions and are living in long-term recovery. "If they want to help individuals and communities recover, they need to listen to people in recovery from this disease. They need to ask people in recovery how they got well and what is required to successfully support yourself in recovery" says Smith.

The problem that Marshall sees with current drug policies and programs is that they are focused on the maintenance of people's addictions and disease prevention, not on the recovery. The questions policy makers seem to be asking is "how can we make it safer for addicts to do drugs?", not "how can we get addicts off of drugs and help them get their lives together?"

So instead of developing more recovery programs, more programs are developed that give addicts access to drugs and tools that keep them stuck in the depths of their addictions.

Neal Berger, the Executive Director of the Cedars Cobble Hills Treatment Center, is calling on the government to fund and execute a national research study on people who are living in long-term recovery from their addiction. He sees real value in studying people who are successfully managing their illness. It's this valuable insight that can lead to effective policy to help addicts achieve recovery.

Berger is encouraging the government to sit down and talk to people who have overcome their addictions. "Like many other diseases, addiction is a chronic illness that needs to be rigorously managed through participation in recovery focused programs" says Berger.

Smith likens this approach to any other strategy one would employ to beat a disease, asking "can you imagine building a cancer strategy without engaging cancer survivors?"

Getting addicts into recovery is easier said than done. Smith knows all too well the challenging road it takes to get there, and a system that enables addictions certainly doesn't make it any easier. A system that actively pushes addicts towards recovery and draws on the real experiences of those who have recovered could make all the difference.

1 comment:

  1. Two concerns I have about Insite Research.
    1) They emphasize repeatedly that they have had no deaths at the facility. I have been practicing medicine for 30 years and I'd just like to say that I have had no deaths in my office for 30 years. Most of us can say this. It goes without saying. What is questioned is whether 'abstinence based treatment centres' or existing 'opioid agonist therapies' such as methadone and buprenorphine aren't a better approach to the problem of IV drug use.
    2) Insite claims for itself a major role in the success of treatment of crime and addiction in the downtown eastside, I just heard Dr. E. Woods make this highly offensive association again at the CSAM conference this weekend, denying the scientifically proven work done by our Downtown Eastside Methadone Maintenance Clinics, the tremendous work by Union Gospel and the Salvation Army Harbour Light facility, the many contributions of Vancouver Coastal Health in the downtown eastside, the improved training by the Vancouver police, and the excellent work of the Vancouver "Drug" court, and all the other scientically proven and fiscally responsible but decidedly 'unsexy' "heavy lifting" workers in the Downtown Eastside. Insite's contribution is "glamor and gloss". It's reminiscient of the study in which we paid criminals not to do crime successfully but those 'projects' didn't offer anything new and are not perpetuated for the same obvious reasons.