Thursday, December 27, 2012
Sunday, December 9, 2012
More on Servants of Hope work
Initiative brings message of hope and recovery
By Erin McPhee, North Shore News
NORTH
Shore residents will be among the volunteers leading by example at an
upcoming event seeking to inspire those struggling with addiction to
take positive steps in their recovery journey.
For the last seven years, the Vancouver-based Servants of Hope Society has provided a holiday meal to those experiencing homelessness as well as those struggling with addiction in the Downtown Eastside. The event, Feeding the Homeless at Christmas in Pigeon Park, is unique as a number of volunteers are in substance abuse recovery themselves, as well as having previously lived in the area.
This year's event will be held Monday, Dec. 17 and Servants of Hope Society founder Sean H. is expecting it to be their biggest yet.
"I couldn't feed myself 10 years ago and with a little hope, 10 years later, I'm now feeding 1,000 with the help of my friends," he says. "If that isn't hope I don't know what is."
In addition to the annual Christmas initiative, Servants of Hope runs a faith-based men's recovery house in East Vancouver.
The annual holiday meal started small, seeing Sean and two of his friends, all three in early recovery, show up in the Downtown Eastside to distribute sandwiches, water, pop and clothing.
They were surprised at the outcome. "They were known in that neighbourhood for many years and they found recovery," he says of the friends who accompanied him, "so we go back down there and next thing you know, there were all these people who remembered and knew them and had never seen them clean and sober."
Those they were serving ran to get others, wanting them to see with their own eyes the trio's success in moving forward on a positive, sober path. "That really, really affected me and it also really affected my two friends," says Sean.
In the years that have followed, Sean has continued to lead the charge in presenting the annual meal, and participation and reach has continued to grow. The 2011 edition saw more than 100 people volunteer (primarily people in recovery, former area residents and some who had been served by the dinner in the past).
"They're all together on this night in that neighbourhood and they're just so grateful to be a part of it, and so happy that they can give back and giving back is the foundation for turning our lives around," says Sean.
"We totally understand what it's like for these people in the Downtown Eastside, for those that we do help, to be in a food line all year long. It's just another food line? No, this is not another food line. This is like nothing they've seen," he adds.
Together they served dinner to approximately 1,000 people in two hours. In addition, "Santa Claus" made an appearance and handed out gifts.
Sean hopes the event continues to convince those they serve that change is possible.
"When all you see is pain and suffering and misery, you need to see hope in order for you maybe to consider that there is hope for you," he says.
Organization for this year's event is on track and while Sean has been overwhelmed by interested volunteers - from throughout the Lower Mainland, including the North Shore - and donations of food, blankets and other gifts, there are a few items he's still seeking. Warm clothing (mittens, gloves, hats and socks), chocolate, gift wrap and ribbon are currently on his wish list, as well as monetary donations to the society.
To make a donation or for more information on the Servants of Hope Society, visit servantsofhope.ca.
emcphee@nsnews.com
For the last seven years, the Vancouver-based Servants of Hope Society has provided a holiday meal to those experiencing homelessness as well as those struggling with addiction in the Downtown Eastside. The event, Feeding the Homeless at Christmas in Pigeon Park, is unique as a number of volunteers are in substance abuse recovery themselves, as well as having previously lived in the area.
This year's event will be held Monday, Dec. 17 and Servants of Hope Society founder Sean H. is expecting it to be their biggest yet.
"I couldn't feed myself 10 years ago and with a little hope, 10 years later, I'm now feeding 1,000 with the help of my friends," he says. "If that isn't hope I don't know what is."
In addition to the annual Christmas initiative, Servants of Hope runs a faith-based men's recovery house in East Vancouver.
The annual holiday meal started small, seeing Sean and two of his friends, all three in early recovery, show up in the Downtown Eastside to distribute sandwiches, water, pop and clothing.
They were surprised at the outcome. "They were known in that neighbourhood for many years and they found recovery," he says of the friends who accompanied him, "so we go back down there and next thing you know, there were all these people who remembered and knew them and had never seen them clean and sober."
Those they were serving ran to get others, wanting them to see with their own eyes the trio's success in moving forward on a positive, sober path. "That really, really affected me and it also really affected my two friends," says Sean.
In the years that have followed, Sean has continued to lead the charge in presenting the annual meal, and participation and reach has continued to grow. The 2011 edition saw more than 100 people volunteer (primarily people in recovery, former area residents and some who had been served by the dinner in the past).
"They're all together on this night in that neighbourhood and they're just so grateful to be a part of it, and so happy that they can give back and giving back is the foundation for turning our lives around," says Sean.
"We totally understand what it's like for these people in the Downtown Eastside, for those that we do help, to be in a food line all year long. It's just another food line? No, this is not another food line. This is like nothing they've seen," he adds.
Together they served dinner to approximately 1,000 people in two hours. In addition, "Santa Claus" made an appearance and handed out gifts.
Sean hopes the event continues to convince those they serve that change is possible.
"When all you see is pain and suffering and misery, you need to see hope in order for you maybe to consider that there is hope for you," he says.
Organization for this year's event is on track and while Sean has been overwhelmed by interested volunteers - from throughout the Lower Mainland, including the North Shore - and donations of food, blankets and other gifts, there are a few items he's still seeking. Warm clothing (mittens, gloves, hats and socks), chocolate, gift wrap and ribbon are currently on his wish list, as well as monetary donations to the society.
To make a donation or for more information on the Servants of Hope Society, visit servantsofhope.ca.
emcphee@nsnews.com
© Copyright (c) North Shore News
Saturday, December 1, 2012
CHRISTMAS APPEAL, 2 GREAT EDITORIALS & an UNPUBLISHED LETTER
The Servants of hope society - outreach and events
Feeding the Homeless at Christmas in Pigeon Park
December 17, 2012 6pm
We are in need of Corporate Sponsorship.
Receipts for Income Tax Deduction Provided
get together and go into the Downtown Eastside to feed the homeless and do outreach
Bringing the message of Hope And Recovery to the Downtown Eastside. The success of the last 6 years of outreach involved over 100 people with minimal financial and material support. We were still able to feed and meet the needs of over 1000 people . The majority of the people involved with this cause have a history of substance abuse and a high percentage of those people came from the downtown eastside and are now free from their addictions and are productive members of society today. It is both a privilege and an honor for me and the people involved being able to give back to those in need during such a dark and lonely time.
http://www.servantsofhope.ca/
CHRISTMAS APPEAL
* * *
Addicts don’t need a new drug
Opinion: They require support to a new way of life
Lorne Hildebrand, executive director of Edgewood Addictions Centre in Nanaimo.
I
read with interest Evan Wood’s opinion (Vancouver Sun, Nov., 3, 2012)
of a new drug, unavailable in Canada that could aid in the battle
against addiction. While I would love to be able to support the notion
that Vivitrol (naltrexone) will be a huge asset in the fight against
addictions, I am highly skeptical.
In my experience as executive director of Edgewood, one of North America’s most respected addiction treatment centres right here in British Columbia, we have yet to find anything that is as effective as well-structured, long-term, abstinence-based residential treatment. No pill, injection, short-term detox or therapy-of-the-month has had any lasting benefit for the majority of substance-dependent people and their families suffering from this disease.
In his article Wood states, “Vivitrol reduced heavy drinking in alcoholics by 25 per cent.” I find no comfort in the thought that an alcoholic might only drink three out of four days, or cut back from 40 ounces of Scotch daily to 30 ounces. The terrible impact to an alcoholic’s health, their family and loved ones involved, will not be significantly reduced by a 25-per-cent decrease in their consumption. An alcoholic advised by his physician that he will die if he takes another drink, will still die at 75 per cent of his drinking.
Absolutely there is a critical role for physicians, psychiatrists and a wide range of mood stabilizing medications in the treatment of addiction. But our experience is many physicians do not fully understand the disease of addiction. In fact, most get very little training in it. It seems treatment often includes substituting one chemical for another. For example, Methadone, an opiate initially developed as a pain killer, may indeed reduce some harms. It is however, still an opiate. I believe the goal should be to have people come off opiates completely. And, don’t be fooled by the notion that opiate addicts never get clean. Many who have come through Edgewood for treatment for their addiction have remained clean for years.
Edgewood has three full-time, physicians who specialize in addiction medicine. We could not do proper treatment without them, but they are just part of a multi-disciplinary team that includes addictions counsellors, nurses, dietitians, fitness specialists, spiritual advisers and other staff.
It may surprise you to learn that the vast majority of actively using, substance- dependent people hold down full-time jobs. Yet discussion and proposed solutions are often focused around addressing Vancouver’s Downtown Eastside issues. While a case can be made for medications such as naltrexone being prescribed for an at-risk population, it should not be assumed that this is the solution for the vast majority of Canadians suffering from the disease.
Post-treatment strategies or “aftercare” plans may include anti-psychotic or anti-depressant medications, but in most cases, they do not include anti-addictions medicines. Remember Antabuse? The drug caused a mild to severely unpleasant reaction when alcohol was consumed. It also was touted as the answer to alcoholism. Perhaps good in theory, but in reality the alcoholic, so driven by the disease, would drink through the sickness or stop taking the medication. It is now rarely used.
Rather than creating a reliance on another drug to achieve sobriety, we need to encourage a new way of life, a new emotional reality and connect people to a strong support system that will keep them from using.
The questions we need to answer are whether society wants to invest in the long-term costs of properly treating this disease and whether substitution therapy or any drug therapy, as quick treatment is an acceptable solution?
My answer is that many of the most challenging people we have worked with, in the direst of circumstances, have responded to abstinence-based treatment. They have regained their lives, their jobs, their families and their sense of self- respect and self-worth. They are wonderful human beings in recovery, a pleasure to know and befriend. I am not convinced medications like Vivitrol will achieve those same results.
Lorne Hildebrand is the executive director of Edgewood Addictions Centre in Nanaimo. For more information see www.edgewood.ca
* * *
In my experience as executive director of Edgewood, one of North America’s most respected addiction treatment centres right here in British Columbia, we have yet to find anything that is as effective as well-structured, long-term, abstinence-based residential treatment. No pill, injection, short-term detox or therapy-of-the-month has had any lasting benefit for the majority of substance-dependent people and their families suffering from this disease.
In his article Wood states, “Vivitrol reduced heavy drinking in alcoholics by 25 per cent.” I find no comfort in the thought that an alcoholic might only drink three out of four days, or cut back from 40 ounces of Scotch daily to 30 ounces. The terrible impact to an alcoholic’s health, their family and loved ones involved, will not be significantly reduced by a 25-per-cent decrease in their consumption. An alcoholic advised by his physician that he will die if he takes another drink, will still die at 75 per cent of his drinking.
Absolutely there is a critical role for physicians, psychiatrists and a wide range of mood stabilizing medications in the treatment of addiction. But our experience is many physicians do not fully understand the disease of addiction. In fact, most get very little training in it. It seems treatment often includes substituting one chemical for another. For example, Methadone, an opiate initially developed as a pain killer, may indeed reduce some harms. It is however, still an opiate. I believe the goal should be to have people come off opiates completely. And, don’t be fooled by the notion that opiate addicts never get clean. Many who have come through Edgewood for treatment for their addiction have remained clean for years.
Edgewood has three full-time, physicians who specialize in addiction medicine. We could not do proper treatment without them, but they are just part of a multi-disciplinary team that includes addictions counsellors, nurses, dietitians, fitness specialists, spiritual advisers and other staff.
It may surprise you to learn that the vast majority of actively using, substance- dependent people hold down full-time jobs. Yet discussion and proposed solutions are often focused around addressing Vancouver’s Downtown Eastside issues. While a case can be made for medications such as naltrexone being prescribed for an at-risk population, it should not be assumed that this is the solution for the vast majority of Canadians suffering from the disease.
Post-treatment strategies or “aftercare” plans may include anti-psychotic or anti-depressant medications, but in most cases, they do not include anti-addictions medicines. Remember Antabuse? The drug caused a mild to severely unpleasant reaction when alcohol was consumed. It also was touted as the answer to alcoholism. Perhaps good in theory, but in reality the alcoholic, so driven by the disease, would drink through the sickness or stop taking the medication. It is now rarely used.
Rather than creating a reliance on another drug to achieve sobriety, we need to encourage a new way of life, a new emotional reality and connect people to a strong support system that will keep them from using.
The questions we need to answer are whether society wants to invest in the long-term costs of properly treating this disease and whether substitution therapy or any drug therapy, as quick treatment is an acceptable solution?
My answer is that many of the most challenging people we have worked with, in the direst of circumstances, have responded to abstinence-based treatment. They have regained their lives, their jobs, their families and their sense of self- respect and self-worth. They are wonderful human beings in recovery, a pleasure to know and befriend. I am not convinced medications like Vivitrol will achieve those same results.
Lorne Hildebrand is the executive director of Edgewood Addictions Centre in Nanaimo. For more information see www.edgewood.ca
* * *
The cure for substance abuse isn’t a pill
Opinion: I know; I've been there and done that
Jeff Vircoe is communications coordinator at Edgewood.
I
didn’t wake up. I came to. Usually abruptly. Panicked. Terrified. The
first five minutes were always the worst. Where was I? Who is that
person beside me? Is anything broken? Where’s my wallet? Where am I
supposed to be? I need water. I smell like a brewery. What did I do with
my car?
The essence of my addiction was simple. Predictable. Vicious. Dangerous. To me and others. It stayed that way from age 13 to age 28. Twenty-four years after my last drink, toke, snort or pill, I still get quiet when I think about it. I am all too aware I can still have all that misery back in the snap of a finger. I’m not cured. I’ve seen too many lose their sobriety date after weeks, months or even multiple years. I’ve been to many, many funerals. But drugs like Vivitrol have me pondering. A pill that would allow me to consume alcohol or other drugs with little to no effect? Wow. Am I ready or willing to wander back into the life I resigned from in 1988?
My answer is no. Why?
I drank for effect. I have no desire to consume alcohol or drugs just for the hell of it. Pay five bucks a drink and not get a buzz? Come on. A painfully shy guy, I drank and drugged because I had found something that for a few years made me feel inside like they looked outside. Smarter. Sexier. Funnier. I loved it. And if I could still be out there dancing with it I would be. But I couldn’t. The blessing, or curse, of being an addict is the thing you love begins killing you. When I reached that point of near death, in my case by my own hand, I had to make a decision to either get it over with, or to ask for help. I didn’t know which one sounded worse. Back then, death had a nice ring to it. Sobering up in a room full of misfits and people who believe in God did not. At least not to me. But not anymore.
Turns out those misfits were my peers. Damn, I too was a misfit. That’s why I drank, remember? So I could fit in. The “God thing” was my stumbling block, but it turned out that I didn’t have to worry. The wording of the step literally says ‘God as we understood Him.’ I didn’t understand him. So I borrowed Pete’s concept. Or Marti’s, or Kelleigh’s. Sure maybe it’s all a big mirage. But I keep going to the meetings, praying, reading about other’s opinions on the “God thing” just the same. And low and behold I’m still sober and mostly happy. And with no urge to use or drink.
So Vivitrol would allow me to re-enter the bar scene and sip the foam off a beer or two again? Hmmm. Why would I want to do that? Without the effect, I already know I won’t fit in. I don’t even like being around drunks or stoners when they’re using. Most of what I hear from them is what I heard from me. Nonsensical, arrogant, pointless arguments or attempts to manipulate others to join me.
I believe if I miss the bar scene, or the lazyboy (the cockpit of my spaceship to la-la land), then there is something wrong with my approach to my life, it’s not even about drinking or drugging. Drinking and drugging were my solutions, not my problem. My problem was my attitude about my life. I just needed another solution.
My solution these days does not come in a pill form. It comes in acceptance. In action. What I’ve been doing for 24 years. At least three meetings a week with guys and gals who know what it’s like to wake up, or come to like I used to. Prayers to something I do not understand. Helping others to get on track. Doing the steps and trying to be rigorously honest about where I am at, no matter how crazy it may sound.
A drink or toke without the buzz would be like hugging a cardboard cut-out of my daughter. Give me the real thing or give me nothing. I don’t do fake. And when it comes to drugs and alcohol, I just can’t do the real thing. That train has left the station.
A friend of mine once told me something that has saved me many times. He said “We realize the boat we are asking you to row is invisible. Row anyway.”
The boat is not a pill.
Jeff Vircoe, a former weekly newspaper and magazine editor and recipient of the Stuart Keate Memorial Award for writing, is communications coordinator at Edgewood. He lives in Parksville.
The essence of my addiction was simple. Predictable. Vicious. Dangerous. To me and others. It stayed that way from age 13 to age 28. Twenty-four years after my last drink, toke, snort or pill, I still get quiet when I think about it. I am all too aware I can still have all that misery back in the snap of a finger. I’m not cured. I’ve seen too many lose their sobriety date after weeks, months or even multiple years. I’ve been to many, many funerals. But drugs like Vivitrol have me pondering. A pill that would allow me to consume alcohol or other drugs with little to no effect? Wow. Am I ready or willing to wander back into the life I resigned from in 1988?
My answer is no. Why?
I drank for effect. I have no desire to consume alcohol or drugs just for the hell of it. Pay five bucks a drink and not get a buzz? Come on. A painfully shy guy, I drank and drugged because I had found something that for a few years made me feel inside like they looked outside. Smarter. Sexier. Funnier. I loved it. And if I could still be out there dancing with it I would be. But I couldn’t. The blessing, or curse, of being an addict is the thing you love begins killing you. When I reached that point of near death, in my case by my own hand, I had to make a decision to either get it over with, or to ask for help. I didn’t know which one sounded worse. Back then, death had a nice ring to it. Sobering up in a room full of misfits and people who believe in God did not. At least not to me. But not anymore.
Turns out those misfits were my peers. Damn, I too was a misfit. That’s why I drank, remember? So I could fit in. The “God thing” was my stumbling block, but it turned out that I didn’t have to worry. The wording of the step literally says ‘God as we understood Him.’ I didn’t understand him. So I borrowed Pete’s concept. Or Marti’s, or Kelleigh’s. Sure maybe it’s all a big mirage. But I keep going to the meetings, praying, reading about other’s opinions on the “God thing” just the same. And low and behold I’m still sober and mostly happy. And with no urge to use or drink.
So Vivitrol would allow me to re-enter the bar scene and sip the foam off a beer or two again? Hmmm. Why would I want to do that? Without the effect, I already know I won’t fit in. I don’t even like being around drunks or stoners when they’re using. Most of what I hear from them is what I heard from me. Nonsensical, arrogant, pointless arguments or attempts to manipulate others to join me.
I believe if I miss the bar scene, or the lazyboy (the cockpit of my spaceship to la-la land), then there is something wrong with my approach to my life, it’s not even about drinking or drugging. Drinking and drugging were my solutions, not my problem. My problem was my attitude about my life. I just needed another solution.
My solution these days does not come in a pill form. It comes in acceptance. In action. What I’ve been doing for 24 years. At least three meetings a week with guys and gals who know what it’s like to wake up, or come to like I used to. Prayers to something I do not understand. Helping others to get on track. Doing the steps and trying to be rigorously honest about where I am at, no matter how crazy it may sound.
A drink or toke without the buzz would be like hugging a cardboard cut-out of my daughter. Give me the real thing or give me nothing. I don’t do fake. And when it comes to drugs and alcohol, I just can’t do the real thing. That train has left the station.
A friend of mine once told me something that has saved me many times. He said “We realize the boat we are asking you to row is invisible. Row anyway.”
The boat is not a pill.
Jeff Vircoe, a former weekly newspaper and magazine editor and recipient of the Stuart Keate Memorial Award for writing, is communications coordinator at Edgewood. He lives in Parksville.
© Copyright (c) The Vancouver Sun
* * *
Here is the Letter to the Editor sent to the Vancouver Sun, that was not published, followed by the news item that prompted the letter:
I work with addicts in recovery and I can tell you for a fact that when
OxyContin was widely available last year, the abuse was not 'notable' or
'troubling'; it was an epidemic.You must have noticed that every
pharmacy and every doctor's office and clinic had conspicuous signage
declaring "NO OXY ON THE PREMISES."
Now Leona Aglukkaq, our federal Health Minister, flying fast in the face of advice from doctors, researchers, police chiefs and Provincial health ministers, has approved new generic versions of this nightmare. Her ironic defense is that she doesn't want politics to interfere with science. Huh?
Aglukkaq is an aboriginal from the Far North. No demographic is more tragically effected by this blind decision. What is she thinking?
David Berner
Drug Prevention Network of Canada
Now Leona Aglukkaq, our federal Health Minister, flying fast in the face of advice from doctors, researchers, police chiefs and Provincial health ministers, has approved new generic versions of this nightmare. Her ironic defense is that she doesn't want politics to interfere with science. Huh?
Aglukkaq is an aboriginal from the Far North. No demographic is more tragically effected by this blind decision. What is she thinking?
David Berner
Drug Prevention Network of Canada
Aglukkaq approves 'Hillbilly heroin' copies
Manufacturers have been asked to submit risk management plans on safe use of the generics
By Sharon Kirkey, Postmedia News
Health
Canada has swiftly approved six generic copies of the widely abused
painkiller OxyContin, despite urgings from some of the country's leading
pain doctors and researchers to delay approval in the name of "patient
and public safety."
The first generic versions of the drug dubbed "Hillbilly heroin" were authorized by Health Canada on Monday - one day after the patent held by Purdue Pharma for its long-acting formulation of oxycodone, the active ingredient in OxyContin, expired.
Purdue began phasing out OxyContin earlier this year, replacing it with OxyNEO. Oxy-NEO tablets have been hardened to make them more difficult to abuse. When crushed, the pills form a thick, gummy-like gel in water, making them harder to snort or inject.
But the generics will use the same older, "easy to tamper with" formulation in the now discontinued OxyContin, doctors who treat patients with chronic pain or addiction wrote in a letter to federal health minister Leona Aglukkaq Nov. 19.
"If there were some foolproof way to stratify patients into low risk vs. high risk, perhaps we could provide the generic versions to low-risk patients and reserve the tamper-resistant formulations for the higher risk patients," read the letter, endorsed by 34 doctors.
But even with screening and monitoring, "it is always a challenge in practice to be confident that a given patient is using pain medication appropriately."
There is also a risk that public and private insurers would consider the drugs interchangeable, they added, and that pharmacists would automatically substitute a prescription for OxyNEO that was specifically prescribed for a high-risk patient, with one of the cheaper generics.
Provincial health ministers, as well as the Ontario Association of Chiefs of Police, had appealed to Aglukkaq to delay approval of generic Oxy-Contin. But Aglukkaq said she is compelled by law not to withhold approval for a drug that is otherwise considered safe and effective for its intended use.
"The minister has made it clear that she doesn't feel it's the place for politicians to interfere with the scientific review process," her spokesman, Steve Outhouse, said Tuesday. "It's fine for doctors to write a letter saying, 'Don't approve this drug,' " Outhouse said. "The reality is that this drug never hits the streets unless it is prescribed. So if there are 34 doctors who are concerned about it, none of them need to prescribe a generic version of OxyContin to anyone."
Health Canada said manufacturers have been asked to submit "risk management plans" on the safe use of the generics. Licensed dealers have also been told to report spikes in sales, sudden changes in distribution patterns or other potential signs of diversion.
Montreal physician Dr. Mark Ware said the government has approved a drug formulation with known health hazards. He said data from the United States suggested that removal of OxyContin from the market has led to reduced rates of oxycodone abuse in that country.
Opening the market to generics "means that it's now fair game once again for abuse," said Ware, director of clinical research at the Alan Edwards Pain Management Unit at the McGill University Health Centre in Montreal.
Generic drug makers "are not interested, and have never been interested in doing education of physicians," he said. "I can't see them stepping up and driving the opioid use guidelines out to physicians and making sure that they're implemented."
The first generic versions of the drug dubbed "Hillbilly heroin" were authorized by Health Canada on Monday - one day after the patent held by Purdue Pharma for its long-acting formulation of oxycodone, the active ingredient in OxyContin, expired.
Purdue began phasing out OxyContin earlier this year, replacing it with OxyNEO. Oxy-NEO tablets have been hardened to make them more difficult to abuse. When crushed, the pills form a thick, gummy-like gel in water, making them harder to snort or inject.
But the generics will use the same older, "easy to tamper with" formulation in the now discontinued OxyContin, doctors who treat patients with chronic pain or addiction wrote in a letter to federal health minister Leona Aglukkaq Nov. 19.
"If there were some foolproof way to stratify patients into low risk vs. high risk, perhaps we could provide the generic versions to low-risk patients and reserve the tamper-resistant formulations for the higher risk patients," read the letter, endorsed by 34 doctors.
But even with screening and monitoring, "it is always a challenge in practice to be confident that a given patient is using pain medication appropriately."
There is also a risk that public and private insurers would consider the drugs interchangeable, they added, and that pharmacists would automatically substitute a prescription for OxyNEO that was specifically prescribed for a high-risk patient, with one of the cheaper generics.
Provincial health ministers, as well as the Ontario Association of Chiefs of Police, had appealed to Aglukkaq to delay approval of generic Oxy-Contin. But Aglukkaq said she is compelled by law not to withhold approval for a drug that is otherwise considered safe and effective for its intended use.
"The minister has made it clear that she doesn't feel it's the place for politicians to interfere with the scientific review process," her spokesman, Steve Outhouse, said Tuesday. "It's fine for doctors to write a letter saying, 'Don't approve this drug,' " Outhouse said. "The reality is that this drug never hits the streets unless it is prescribed. So if there are 34 doctors who are concerned about it, none of them need to prescribe a generic version of OxyContin to anyone."
Health Canada said manufacturers have been asked to submit "risk management plans" on the safe use of the generics. Licensed dealers have also been told to report spikes in sales, sudden changes in distribution patterns or other potential signs of diversion.
Montreal physician Dr. Mark Ware said the government has approved a drug formulation with known health hazards. He said data from the United States suggested that removal of OxyContin from the market has led to reduced rates of oxycodone abuse in that country.
Opening the market to generics "means that it's now fair game once again for abuse," said Ware, director of clinical research at the Alan Edwards Pain Management Unit at the McGill University Health Centre in Montreal.
Generic drug makers "are not interested, and have never been interested in doing education of physicians," he said. "I can't see them stepping up and driving the opioid use guidelines out to physicians and making sure that they're implemented."
© Copyright (c) The Vancouver Sun
Tuesday, November 27, 2012
DRUG AWARENESS WEEK
Drug Prevention Network President, Chuck Doucette, spent many years with the RCMP working the DARE program (Drug Abuse Resistance Education), one of Canada's best and longest running prevention programs for and with school kids.
It was in that capacity that Chuck appeared last Wednesday on CKNW Radio.
You can hear that excellent conversation with Bill Good by going to the URL below:
http://www.cknw.com/news/audiovault/index.aspx
and selecting November 21 at 11am.
If you want to skip the short newscast, just slide the tracking bar along to 6:00 minutes and enjoy.
It was in that capacity that Chuck appeared last Wednesday on CKNW Radio.
You can hear that excellent conversation with Bill Good by going to the URL below:
http://www.cknw.com/news/audiovault/index.aspx
and selecting November 21 at 11am.
Friday, November 23, 2012
Marijuana is harmless? Are we blinded by a smoke screen?
ROBERT
EVERETT-GREEN
The Globe
and Mail
Published
Thursday, Nov. 22 2012, 4:59 PM EST
It seems that plenty of people have bought the idea that marijuana is a harmless herb, or better. Stories proclaiming the benefits of “medical marijuana” – for ailments as varied as arthritis, MS, glaucoma and Alzheimer’s – abound in mainstream media like International Business Times, and at patient support sites such as Livestrong.org. Voters in Washington and Colorado recently approved measures to begin legalizing pot, and a reinvigorated movement in B.C. is pushing for similar changes. A poll in the summer showed that two-thirds of Canadians are okay with decriminalizing weed for personal use.
Pot supporters promote its supposed benefits at big trade shows like the Treating Yourself Expo, which celebrated its third annual edition in May in Toronto. Doctors aren’t nearly so well mobilized on the issue, but many say the health risks of smoking marijuana are more extensive and better understood than ever before.
“There’s a pretty potent lobby that makes claims about the medical benefits of cannabis, and anybody who disputes them is labelled part of the war on drugs,” says Dr. Meldon Kahan, medical director of the Substance Use Service at Women’s College Hospital in Toronto. “But there’s no role, or hardly any role, for smoked cannabis in the treatment of chronic pain. There are safer alternatives, such as cannabis in pill form or inhalers. There are toxins in cannabis smoke that are carcinogens, and that accelerate heart disease. Smoked cannabis is addicting, unsafe during pregnancy and especially dangerous for young people, in terms of triggering psychosis, depression and mood disorders.”
According to Health Canada, addiction is a complex phenomenon that includes psychological cravings, difficulties in controlling use, symptoms of withdrawal, and persistence in the addictive activity even when it is obviously damaging one’s health, relationships and day-to-day functioning. All can apply to heavy cannabis smokers, says Kahan.
Teens are still developing neurologically, he says, which makes them more vulnerable than adults to the adverse effects of marijuana, especially of the powerful strains for which B.C. is famous. A recent report in the Proceedings of the National Academy of Sciences about a long-term study of more than 1,000 pot-using teens in New Zealand said that those who continued smoking into their 30s suffered significant cognitive deficits related to memory, reasoning and ability to process information.
According to a 2007 report by Health Canada, 8.2 per cent of young people use cannabis on a daily basis. Many teens smoke weed to cope with the anxieties of adolescence, and find it very tough to quit.
“People who take cannabis regularly get a mood-leveling effect,” Kahan says. “When they stop suddenly, there’s a tremendous rebound anxiety that can go on for days or weeks, and that makes them want to take it again.”
Many young users smoke it with tobacco, a combo that researchers are finding to be much more addicting than marijuana alone. Dr. Bernard Le Foll, a leading researcher at Toronto’s Centre for Addiction and Mental Health, says his research shows that when nicotine and tetrahydrocannabinol (or THC, the element in pot that delivers the “high”) are received together, they magnify each other’s effects on brain chemistry.
A 2009 study at the University of B.C. led by Dr. Wan Tan found “a significant synergistic effect between marijuana smoking and tobacco smoking” that increases risk for chronic obstructive pulmonary disease. COPD (which includes emphysema and chronic bronchitis) can aggravate the risk of pneumonia, heart problems, glaucoma and lung cancer.
John Westland, a social worker at the Hospital for Sick Children’s Adolescent Substance Abuse Outreach Program, says many of his teenaged patients combine weed and tobacco in the quick-hit form known as “poppers” (not to be confused with the amyl nitrites inhaled at clubs and raves). They use a modified water pipe that delivers a head rush they don’t get from smoking straight marijuana.
“From my experience with my patients, I would say the addiction potential is higher for sure,” Westland says. The relative cheapness of poppers is also a draw, as is the societal notion that pot is pretty much okay, and that a few cigarettes won’t hurt you. “As their perception of risk goes down, use goes up,” Westland says. Withdrawal is an ugly process that deprives jittery patients of sleep and appetite, he says, and can drag on through cycles of relapse and repeated efforts.
So why is weed regarded as relatively benign? How can any kind of smoking seem okay in 2012?
Pot’s current reputation has certainly benefited from growing skepticism about established medicine. Marijuana is seen as whole and natural, not a refined pharmaceutical produced by a big corporation. Weed as a painkiller or treatment for nausea may appeal to the same people who seek out herbal equivalents of pharmaceuticals such as Valium, whose effects can be mimicked by valerian root.
Pot also benefits from current demographics. In contrast to seniors of, say 20 years ago, aging boomers today have fond memories of sharing a joint in their college dorm, and may not be aware that today’s marijuana is probably much more potent than what they smoked in ’68.
The widespread feeling that prohibition has failed both users and society as a whole has also helped. Surely a little pot smoking can’t be more harmful, say weed activists, than a harsh legal regime that has cost us so much in money and damaged lives.
“Whatever people think the harms of cannabis are, those are best reduced by a legally regulated system,” says Dana Larsen, leader of a Sensible B.C. initiative to decriminalize weed in B.C. In any case, he says, “The use of cannabis since the 1960s has pretty much steadily risen in Canada, as has the severity of the laws, so the idea that prohibition is doing anything to keep cannabis out of the hands of youth is totally wrong.”
No doubt. What does work is information. A 2011 survey report from the U.S. National Institute on Drug Abuse found that while cannabis use is increasing among American high school students, tobacco smoking has dropped by half since 1997. In those 15 years, tremendous societal scorn has come down on smoking, the ill effects of which are pictured on every cigarette pack. Marijuana, meanwhile, has acquired a public image almost as benign as wheatgrass. Perhaps our long-running relationship with Mary Jane is due for another change.
Sunday, November 18, 2012
Tuesday, November 13, 2012
Young Adults & 12 Steps?
The article and the accompanying note were contributed by DPNC President Chuck Doucette:
This study might be "no brainer" for some but others seem to need
convincing that the 12 Step programs work.
Monday, November 12, 2012
Wednesday, November 7, 2012
SMOKE AT THE BALLOT BOX
2012 State Ballot Initiatives
Updated: November 7, 2012
Arkansas
•Arkansas
Medical Marijuana Question – sought
to legalize marijuana under the guise of medicine and allow for the
establishment of marijuana dispensaries licensed by the state. The question was
sponsored by Arkansans for Compassionate Care. Defeated - 52% opposed 48% supported.
Oregon
•Measure
80, Int. 9 Oregon Cannabis Tax Act Initiative
- sought to legalize and regulate the cultivation, possession and sale of
unlimited amounts of marijuana. The measure would also prohibit regulation and
fess to grow hemp. Defeated – 56% opposed 44% supported.
Montana
•Initiative
Referendum 124 - sought to reaffirm legislation
passed in 2011 that replaced the state’s current “medical”
marijuana law and replaced it with a more restrictive program.
Passed – 66% voted to keep legislative
changes to the “medical” marijuana program.
Colorado
•Initiative
64 The Campaign to Regulate Marijuana Like Alcohol –initiative
allows those 21 years of age and older to possess up to one ounce of marijuana
and cultivate six marijuana plants. The initiative also allows for
over-the-counter sale of marijuana, reduces penalties for larger possession
charges and legalizes hemp farming.
Passed-
55% supported 45% opposed.
Massachusetts
•Question
Three– legalizes marijuana under the
guise of medicine and allows for the establishment of marijuana dispensaries. Passed – 63% supported
37% opposed.
Washington
•Initiative
502 – allows adults 21 and
over to purchase marijuana from state-licensed and state-regulated businesses.
Creates a regulatory system, much like the liquor control system, in which a
board oversees licensing of marijuana producers, processors and retailers, and
imposes an excise tax of 25% at each step. Passed – 56% supported 44% opposed.
THE MARRIAGE OF ENFORCEMENT & TREATMENT
In local addictions mythology, The Four Pillars is considered the Holy Grail: Harm Reduction, Enforcement, Prevention and Treatment.
Most citizens have long acknowledged that, from the beginning and in reality, there has only been one pillar - Harm Reduction - and three matchsticks, which are either underfunded or outright maligned.
Many continue to believe that Enforcement and Treatment are natural enemies.
They are not.
Please read this recent study from Scotland which casts a much healthier and optimistic light on the subject.
Most citizens have long acknowledged that, from the beginning and in reality, there has only been one pillar - Harm Reduction - and three matchsticks, which are either underfunded or outright maligned.
Many continue to believe that Enforcement and Treatment are natural enemies.
They are not.
Thursday, October 25, 2012
ANNOUCEMENTS, ANNOUNCEMENTS, ANNOU-ENCEMENTS!
Two of our partners in Recovery work are holding special events in the coming weeks.
Welcome Home is holding an Open House for all in early November. Here is their invitation.
VisionQuest is running a 12 Step Comedy fundraiser in December. If you recognize how funny work and life in Recovery can be, you'll want to join in the fun and support this group.
Check out their poster for this event here.http://dpnoc.ca/wp-content/uploads/2012/10/Xmas-poster-2012.pdf
Welcome Home is holding an Open House for all in early November. Here is their invitation.
VisionQuest is running a 12 Step Comedy fundraiser in December. If you recognize how funny work and life in Recovery can be, you'll want to join in the fun and support this group.
Check out their poster for this event here.http://dpnoc.ca/wp-content/uploads/2012/10/Xmas-poster-2012.pdf
Tuesday, October 16, 2012
DEWY
The video below is a marvelous short piece on some terrific Preventative work that is happening quietly right in our midst.
The item was sent to us by Jay Niver of the Alcohol-Drug Education Service in Surrey. Jay is, as well, one of the creators of the video.
Bravo! and more, please...
The item was sent to us by Jay Niver of the Alcohol-Drug Education Service in Surrey. Jay is, as well, one of the creators of the video.
Bravo! and more, please...
Wednesday, October 10, 2012
REEL RECOVERY FILM FEST - AGAIN!
The film festival kicks off with an evening gala on October 19, which includes food by Culinary Capers, two film screenings, and a live Q & A with Greg Williams and Joe Calendino. Tickets to the opening night gala are $100.
The following day, seven films will be screened from 11 a.m. to 11 p.m. This year’s festival highlights include Bill W., Unguarded, Beauty Mark, Lost in Woonsocket, The Secret World of Recovery, Spare Change, and Lipstick & Liquor.
Individual movie tickets are $5 and a festival pass is $25. Tickets can be purchased online in advance.
Friday, August 17, 2012
CHUCK - TWICE IN A DAY
Just in case any of you are looking for some light entertainment, I have
provided a link to the CKNW talk show that I was on today. In the audio vault
section select today's date and start at 1:00 pm. The show runs for about 30
minutes including all the commercials and news.
Cheers,
Chuck
CHUCK, AL & JON FERRY IN SYNCH & ON TARGET
'Never been a war on drugs, not even close'
Drugs are still too easy to obtain in Vancouver
By Jon Ferry, The Province
Jon Ferry
Photograph by: Graphics, The Province
That's not news to those who've come to know the seedy underbelly of our spaced-out port city. It's been like that for years.
So the finding by the B.C. Centre for Excellence in HIV/AIDS that buying illegal drugs in downtown Vancouver is as easy as going to the nearest supermarket is no surprise either.
Most younger and older drug users surveyed in the centre's latest, taxpayer-funded study said they could obtain everything from heroin and crack cocaine to crystal meth and pot within minutes — 10 minutes, to be precise.
"Perhaps most concerning is the ready availability of drugs that are injected," noted the researchers, who hail from Vancouver and Boston.
Talk about stating the obvious. The open market for drugs in downtown Vancouver, and the horrific social problems it causes, has been a public concern for years.
The question is what to do about it. And the inference in this study — published in the American Journal on Addictions and based on user responses from 2007 — is that the American-style war on drugs, with its emphasis on drug-law enforcement, has been an abject failure.
Indeed, it's clear the drug policy advocated instead by the B.C. Centre for Excellence in HIV/AIDS itself is "harm reduction," focusing on everything from safe-injection sites to drug legalization.
This is, in fact, the politically correct approach that's been in vogue in Vancouver's drug-riddled downtown for years — without apparent effect. And study co-author Dr. Evan Wood, a Vancouver physician, is an eloquent champion of it.
"Despite enormous taxpayer investments in enforcing laws aimed at reducing the supply of illegal drugs, Canada's streets remain awash in heroin and cocaine," he stated recently in the National Post.
"Meanwhile, designer drugs such as ecstasy are becoming more readily available to young people than alcohol and tobacco. The war on drugs, like all expensive government programs, should be subject to scrutiny and a value-for-money audit. However, so far, it has been remarkably exempt from accountability."
It could equally well be argued, however, that the main reason why the illegal drug trade continues to flourish in the Lower Mainland like a foul-smelling weed is not because of too much law enforcement, but too little.
The B.C. justice system is notoriously soft on drugs and drug offenders, as at least one sentencing study has shown.
Just ask former Lower Mainland RCMP officer Chuck Doucette, president of the Drug Prevention Network of Canada: "There's never been a war on drugs in Canada, not even close."
It could also be argued that the laissez-faire attitude of our civic leaders toward the government-funded Downtown Eastside drug ghetto has done as least as much to turn troubled/homeless teens into hard-core addicts as have any overzealous police drug crackdowns.
Besides, as former Downtown Eastside beat cop Al Arsenault pointed out Thursday, Vancouver should not be setting drug policy: "Whatever we're doing here is not working."
Maybe Wood and his research team should be studying those cities around the world where it is.
jferry@theprovince.com
© Copyright (c) The Province
Friday, July 6, 2012
Monday, July 2, 2012
TREATMENT WORKS - HUGE NEWS FROM THE U.K.
Many thanks to Darcy Ulmer of Baldy Hughes Therapeutic Community for passing on this study of SUCCESS IN TREATMENT from the U.K.
The next time some quasi-scientist wants to tell folks that treatment does not work, you might quote this study.
National Treatment Agency for Substance Misuse
“Long-term results for those who have been treated in one
year found that nearly half who leave neither need further treatment nor were
found to be involved in drug related off ending”
A LONG-TERM STUDY
OF THE OUTCOMES OF
DRUG USERS LEAVING
TREATMENT
SEPTEMBER 2010
EFFECTIVE TREATMENT CHANGING LIVES
www.nta.nhs.uk
NTA 2010 NTA 2010
EXECUTIVE SUMMARY
Around 200,000 people get help for drug dependency in
England every year. Most are addicted to heroin or crack
cocaine, or both. They will have been using their drug or
drugs of dependency for eight years on average before
they seek treatment.
Given their typical circumstances – heavily addicted,
in poor health and of low self-esteem, often at a peak
of criminal activity before coming into treatment - the
prospects for long-term recovery from drug addiction
can seem bleak. The medical consensus is that heroin
and crack cocaine users take several years to overcome
addiction, and spend repeated attempts in treatment
before they do.
Against this background, the annual statistical reports of
numbers in drug treatment can present a distorted picture
of a treatment system that is subject to a steady ebb and
fl ow of clients over a longer time frame. However the
National Drug Treatment Monitoring System (NDTMS)
database is now extensive enough to enable us to follow
the treatment careers of individuals over successive years.
Consequently the National Treatment Agency for
Substance Misuse (NTA) has analysed the long-term
results for those who have been treated in one year, and
found that nearly half (46%) of those who leave neither
need further treatment, nor were they found to be
involved in drug related offending.
In close co-operation with the Home Office, the NTA
matched four years’ worth of NDTMS data with Drug
Test Records (DTR) and the Drug Interventions Programme
(DIP) data to evaluate the long-term outcomes of drug
treatment for 41,475 clients who left drug treatment in
England in the financial year 2005-06. It includes both
those who left treatment in a planned way, and those
who dropped out.
This is the first time a study of this kind has been
possible.
Although there is no international long-term equivalent
study based on live client data, the results compare
favourably with longitudinal studies about the prospects
of individuals’ recovery from even the most entrenched
addiction.
As a treatment programme for addiction usually takes
longer than a year to complete, these findings provide a
more meaningful assessment of treatment effectiveness
than an annual snapshot. It enhances our understanding
of what success means: for example, it was found that
many of those who ‘drop out’ do not seem to need
further treatment. Most importantly, it shows to users
and all the people and agencies who work with them to
bring about positive change that recovery from addiction
is possible.
KEY FINDINGS:
.Strong evidence that suggests sustained recovery from
addiction was found for almost half of all the clients
discharged from treatment during 2005-06. Around
46% neither came back into treatment, nor had a
drug-related contact with the criminal justice system
in the following four years. (A criminal justice contact
could be with either the Drug Interventions Programme
in the community or prison, or a positive DIP drug test
for cocaine or opiates following arrest for offences such
as burglary, robbery and theft).
.The majority (55%) of all clients who left treatment
during 2005-06 did not return to treatment in the
subsequent four years.
. Of those who left treatment but subsequently re-
offended using drugs, 65% went back into treatment.
. As might be expected, clients who successfully
completed a course of treatment were less likely to
need treatment in later years.
. However, a high rate of those who were originally
categorized as ‘dropping out’ (43%) did not return to
either treatment or drug interventions in the criminal
justice system.
. Those treated for the most addictive substances were
the hardest to treat and more likely to relapse. Problem
drug users addicted to both heroin and crack cocaine in
combination had the poorest long term outcomes.
. Conversely, those leaving treatment for cannabis
and powder cocaine did best with 69% and 64%
respectively not returning during the follow-up period
or being identified as re-offending using drugs.
. Whether someone was discharged from treatment
free of all illegal drugs or free of dependency made
little difference to how likely they were to need further
treatment or commit drug-related crimes.
. Comparison between 2005-06 and 2006-07 treatment
exits with re-presentations measured over three years
showed significant similarity in the long term outcomes
of both cohorts.
2
NTA 2010 NTA 2010
1.1 INTRODUCTION
This paper presents the results of a study to follow up
individuals after leaving structured drug treatment services
in the financial year 2005-06 to see whether in the four
years after leaving, they re-present to drug treatment
again and/or they have a drug related contact with the
criminal justice system, after being arrested for offences
such as burglary, theft and shoplifting.
All findings are based on the analysis of collated
information from drug treatment providers through the
National Drug Treatment Monitoring System (NDTMS),
data collected from the Drug Interventions Programme
through the Drug Interventions Monitoring Information
System (DIMIS) and Drug Test Records (DTR) from
individuals who are arrested. The datasets have been
matched to create a pathway or journey map for a
cohort of individuals exiting treatment and examined to
determine whether there has been further contact with
treatment and/or drug interventions through criminal
justice agencies.
In the context of this report, contact with the Criminal
Justice Service (CJS) refers specifi cally to contacts
recorded
in one of these datasets. It should be noted that while
these are the most common datasets that drug users will
appear in, some clients will have had other CJS contacts
not covered by this data: for example, arrests for a
non-drug related offence for which drug testing is not
standard practice or arrests in areas where drug testing
is not in place and where the client is not otherwise
identified as a drug user.
Individuals were excluded from the study for the following
reasons: that they were in prison at the time of leaving
treatment, that they had been recorded as dying while
in contact with treatment and if they shared attributors
(initials, date of birth and gender) with another
individual.
This report cannot categorically assert that all individuals
who do not return to treatment or DIP are leading entirely
drug free lives as to do so would require each of the
40,000+ clients in the study to be personally contacted
and interviewed. Rather it uses the available datasets to
demonstrate with the best possible evidence whether an
individual’s drug use has become problematic enough
that they require treatment again or have come to the
attention of the criminal justice system and the Drug
Interventions Programme incurring the associated costs
when they do so.
Further analysis to enhance our understanding of
treatment and criminal justice journeys of drug using
offenders is currently being undertaken through the
Home Offi ce Drug Data Warehouse.
1.2 CLIENT PROFILE
A sample of 41,475 clients was identified who had left
the treatment system in 2005-06 as defined by not
being in contact at the end of the year. Two thirds of the
cohort (67%) were problem drug users (PDUs), i.e. were
recorded as presenting for treatment for opiates and/or
crack cocaine.
Over two fifths of all clients presented with ‘opiates
only’
(42%) at the beginning of their latest treatment journey.
Powder cocaine presentations were fairly evenly split
between those in the 18-24 and 25-29 age bracket (28%
and 24% respectively).
Almost one-quarter of treatment exits were planned
(24%) – defi ned either as ‘treatment completed’ or
‘treatment completed – no drug use’, both denoting the
clients had completed treatment successfully, leaving free
of dependency.
The cohort was selected from the 54,000 adults
discharged from structured drug treatment in 2005-06.
Individuals were excluded from the study if they were
in prison at the time of leaving as they will have been
incarcerated for part or all of the study and also as many
will have continued receiving treatment during and
directly after custody. In addition, as individuals were
identifi ed by only attributors (initials, date of birth and
gender) rather than names and addresses, any duplicate
attributors were excluded.
Once the cohort of treatment leavers in 2005-06 was
selected, it was then necessary to be able to determine
if they had subsequently either returned to treatment or
had shown up in any of these criminal justice datasets.
This was ascertained by bringing together data from
the NDTMS and DIP including that collected through
mandatory drug testing of arrestees covering the period
2006-07 to 2009-10. Once this dataset was assembled it
was then possible to see if any of the 41,475 clients had
turned up again in the following four years.
3
NTA 2010 NTA 2010
TREATMENT
LEAVERS
2005-06
2006-2010
NDTMS
DIR
PRISON & COMMUNITY
DRUG TEST
2006-2010
2006-2010
The datasets that have been used here are the most
common that people that are using drugs problematically
will turn up in. Therefore an individual not subsequently
appearing in any of them after leaving drug treatment
would indicate a likelihood of sustained recovery from
dependency. However, as noted previously, they may
have presented to other criminal justice agencies having
committed offences triggered by their drug use and they
will not be identified within this piece of work.
There will sadly be a small number of clients who died
after they left treatment during the four year follow up
period and due to the methodology used it has not been
possible to exclude them from the study. It is recognised
that their inclusion will marginally over estimate the
numbers who are in ongoing recovery. Clients recorded as
having died in treatment were, however, excluded from
analysis at the outset.
Conversely, because the attributors and not the full
names of clients have been used in the analysis, there is a
chance that when an individual is later found in a dataset
it is not in fact the same person as in the original sample,
but instead someone sharing their initials, date of birth
and gender. Although steps have been taken to limit
false-matching it has not been possible to entirely avoid
this, nor the effect that this will have in over estimating
by
a small amount the numbers who re-present.
A detailed explanation of the methodology used can be
found in appendix A.
4
NTA 2010 NTA 2010
2 THE RESULTS OF THE STUDY
The analysis of matched data revealed that 46% of clients
in the study did not return either to drug treatment or
to drug interventions within the criminal justice system
(CJS) within four years. The 22,428 re-presentations to
drug treatment or to the criminal justice system mostly
comprised of individuals who returned directly back to
structured treatment; however, a sizable proportion had
their first subsequent contact at the custody suite and in
prison following their initial discharge in 2005/06. The
diagram below demonstrates the fi rst subsequent event
of the 41,475 clients in the four years following their
discharge from drug treatment.
TREATMENT EXIT 2005-06
(N=41,475)
NO SUBSEQUENT EVENT OF TREATMENT OR
DRUG-RELATED CRIMINAL JUSTICE CONTACT
N=19,047 (46%)
SUBSEQUENT EVENT
N= 22,428 (54%)
TOTAL THAT RETURN TO
TREATMENT
N= 18,666 (45%)
n=11,641 (52%)
n=3,417 (15%)
RE-PRESENT TO DTR
n=5,571 (25%)
RE-PRESENT TO PRISON
n=1,799 (8%)
RE-PRESENT TO
COMMUNITY DIP
TOTAL THAT HAVE INITIAL SUBSEQUENT DRUG-RELATED
EVENT IN CJS N=10,787
n=7,025 (65%)
5
NTA 2010 NTA 2010
Just under half of the clients discharged returned to
treatment 18,666 (45%), with 11,641 re-presenting
straight to treatment and a further 7,025 having a drug-
related criminal justice contact fi rst and then receiving
structured drug treatment afterwards. The remaining
3,762 clients had a subsequent drug-related contact with
the CJS but then didn’t have a further drug treatment
contact.
As would be expected, clients who left treatment
successfully were less likely to need further treatment
than those who dropped out, with 57% of clients having
a planned discharge either not returning to treatment or
to drug interventions within the CJS. As can be seen from
the table below, there was little discernible difference
in outcomes between the two recorded categories of
successful discharge: either ‘treatment completed’ or
‘treatment completed – no drug use’, both of which
denote the client has left free of dependency.
Perhaps more surprising was the re-presentation rates
of those who dropped out of treatment: more than two
fifths of those clients with an unplanned exit (43%) did
not re-present at any time in the subsequent four years,
suggesting that many had already received what they
needed to overcome their dependency before choosing
to leave. This corroborates what some practitioners
have argued: that although drop-out is usually signalled
by relapse, a proportion of those in treatment simply
walk away once it has met their clinical needs without
engaging with the formal administrative discharge
process required by NDTMS.
Analysis of the time elapsed between initial discharge
and re-engagement with services indicated no discernible
difference between planned and unplanned exits.
The proportion of clients readmitted to treatment or drug
interventions in the criminal justice system within the
four-year window varied greatly between drug groups,
with 64% of clients using either crack cocaine, opiates
or both returning, compared with only 33% of clients
using other drugs. Those who presented originally with
combined opiate and crack cocaine use were more likely
to reappear than those with sole use of either drug (63%
opiate only, 51% crack only and 72% opiate and crack
in combination). This is consistent with previous studies,
which have identifi ed worse outcomes associated with
poly drug users.
The probability of not returning to treatment or drug
interventions in the CJS was notably higher for cannabis
and powder cocaine users, with 69% and 64% not representing
to either.
Reason for leavingtreatmentNumber ofindividuals
leavingtreatment 2005/06Number notreturning totreatment / CJSPercentage
notreturning
Completed -
no drug use
3353 1886 56
Completed 6417 3650 57
Unplanned 31705 13511 43
6
NTA 2010 NTA 2010
Differing rates of re-presentation were observed between
the age groups, with those aged 40+ being least likely to
return (43%), followed by 18-24 year olds (54%). Those
aged 25-29 were the most likely to reappear, with 60%
having done so.
RATES OF RE-PRESENTATION TO
TREATMENT/CJS BY SUBSTANCE
OPIATES ONLY
CRACK COCAINE ONLY
OPIATES AND CRACK COCAINE
COCAINE POWDER
CANNABIS
OTHER
0% 20% 40% 60% 80%
RATES OF RE-PRESENTATION TO
TREATMENT/CJS BY AGE GROUP
40+
0% 20% 40% 60% 80%
7
NTA 2010 NTA 2010
However, the relationship between age group and
readmission rates was not uniform across presenting
substances. The lower incidence of readmission in the top
age band was clearly visible among opiate only users, but
there was no discernible relationship between age and
readmission rates for crack cocaine only users.
PROPORTION OF READMISSIONS FOR ALL 2005-06
EXITS (N=41,475)
18-24 25-29 30-34 35-39 40+
0%
10%
20%
30%
40%
50%
60%
70%
ALL
OPIATES ONLY
CRACK COCAINE ONLY
CANNABIS
TIME TO RE-PRESENT (N=22,428)
AGE GROUP
LESS THAN A YEAR
1 TO 2 YEARS
Fifty-seven percent of individuals who returned did so in
the first year and the number of re-presentations roughly
halved between each year after that. Many of those
whose fi rst subsequent contact was with the CJS were
later re-engaged in treatment. At 12 months following
discharge, 30% of those appearing first in CJS data
had also re-started treatment; after four years, 65% of
everyone with a subsequent CJS contact also had further
treatment.
2 TO 3 YEARS
3 TO 4 YEARS
The analysis also demonstrated that those who had an
unplanned exit (categorised as ‘dropped out’) and a
subsequent event, came back quicker than those who
had a planned exit, with 59% of subsequent contacts
occurring within a year compared with 47%.
Further analysis has been carried out to compare the
representation
rates of clients leaving structured treatment
services in 2006-07 with those found in 2005-06, to see
if similar rates and profi les of those not returning were
found. In most cases they were and the results of this
work can be found in appendix B.
8
18-24 25-29 30-34
AGE GROUP
35-39 40+
0%
10%
20%
30%
40%
50%
60%
70%
80%
NTA 2010 NTA 2010
3 CONCLUSION
The NTA has completed an evaluation of the outcomes
of people leaving drug treatment using an initial cohort
of 41,475 clients leaving structured treatment during
2005-06 and seeing if they subsequently came back
to treatment or turned up in drug interventions in the
criminal justice system (CJS).
Examination of all clients exiting in 2005-06 revealed
that 46% didn’t return to drug treatment nor had a drug
related contact with the CJS in the following four years.
This would suggest the majority of these individuals
are managing to sustain their recovery from addiction
though it is not possible to confirm this from the analysis
presented in this report.
There were significant variations in the rates of
representations
depending on the substances that the
clients had presented with, demonstrating the difficulty
of achieving long term recovery when using both opiates
and crack cocaine.
Successfully completing a treatment episode was the
best predictor of long term outcomes, but there were
also a significant proportion of those clients who were
not recorded as completing their course of treatment,
who appeared to have taken the benefits from the
interventions they received and overcome dependency in
the four years of this study.
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