AT THE PRECIPICE

In physics and finance and a few other human concerns, there is a moment called the tipping point. It is that Nano-second just before the break boundary when something becomes entirely something else. Kitty Hawk is suddenly the Apollo Mission.

In this country, we have reached that tipping point when it comes to addictions and recovery.

It was only a scant 20 years ago, that Vancouver Mayor Philip Owen began talking about something called Harm Reduction, the notion that the very least we could do for these poor bedraggled, mystifying infuriating crazy drug addicts was ‘make them comfortable.’ Give them something and some place that would not cure them, but at a minimum keep them from getting diseases from using shared needles and other unsavory practices.

We had already been giving some addicts a substitute lab-made narcotic called methadone for many years. Soon we were giving many, many more people methadone and free heroin and free crack pipe kits and free alcohol and nice tidy, nurse-run places to shoot up. Insite in Vancouver’s Downtown East Side is world famous and considered a great role model for civic minded people all over the world who clamor to open as many similar locations as Cineplexes.

We don’t have mobile cancer clinics or osteoporosis wagons – even though we have hugely skewed aging populations in this country – but many mayors are shopping for mobile ‘safe injection’ units to patrol the leafier neighbourhoods of towns hither and yon.

Today, the ideology of Harm Reduction holds sway in every corner of the community – health authorities, legislatures, parliament, doctors, psychiatrists, universities and colleges.

Sitting on my desk today is a 77 page document entitled “A Guideline for the Clinical Management of Opioid Use Disorder.” It is published and distributed by the British Columbia Ministry of Health (The retiring Minister will be heading up a medical marijuana enterprise when he returns to civilian life.) and something called the British Columbia Centre on Substance Use. The list of well-initialed academics who are contributors or reviewers to this new bible runs a full three pages. Topping the many individuals, groups, associations and governments to whom grateful acknowledgements are offered is the College of Pharmacists of British Columbia.

Residential treatment can be found on page 21. It is largely dismissed due to lack of ‘evidence.’

Everything else in this hefty tome claims to be based on ‘science.’

What is everything else?

Pharmaceuticals, of course.

At this point, let’s remind the reader of the first principle of journalism. Follow the Money.

Keep that uppermost as you read on. Here are some numbers

Last year and the year before, the Province of British Columbia spent $365 Million on a four square block of land in Vancouver called the Downtown East Side. There are over 100 social service agencies plying their trade in that neighbourhood. Many of these non-profits have Executive Directors being paid in six figures.

The same government spent about $100 Million on methadone, but those monies are shifted across the table to another expenditure column so they don’t really show up under the budget of Mental Health & Addictions.

We are currently supporting over 20,000 human beings on long term methadone maintenance with no known or projected date to taper off and quit.

Everyone is aware of the worldwide nightmare and tragedy called Fentanyl.

But not enough people know these two dreadful facts:

One. Of the people who die of a Fentanyl overdose, 20% of them are methadone users. Whoops! How well is that idea working?

Two. Emergency Response Team members, most of whom are suffering massively from PTSD having to attend to addicts in overdose too often, will tell you that they are mightily tired of reviving a guy named Eddie 5 times a day. The problem with the mythical Eddie is that no one is allowed to revive him and then take him to a recovery centre so that he could start the hard and honorable work of getting away from his addictions. And the reason that EMT folks cannot take that extra step is because we, as a society believe that it is Eddie’s Charter given right to keep being a fool, hang the cost to the public purse.

Now, I have worked successfully with addicts for many years now and I can’t imagine bringing Eddie back to life and NOT taking that extra step.

It is important at this juncture to recognize that addictions are not only a problem and a scourge and a tragedy and a stain on our lives, but they are also very Big Business.

The Harm Reductionists, who at the moment are in the driver’s seat, are exactly like the addicts they fail to help. The addict wants to simplify the challenges and exigencies of daily life. Instead of dealing with the mortgage, the spouse, the business partner, the kids, the neighbour or the guy whizzing by at dangerous speeds, the addict has a drink or a line of coke or a needle or a pipe. He or she bottles and encapsulates all of life’s problems. Simple. The Harm Seduction people also want a simple answer to a complex problem. We’ll give them a substitute drug and a place to use and call it a day.

This might work if the substance was the issue. It is not.

The substance is the symptom of a much larger and puzzling malaise. Work and time are the solutions.

The people who are running the great official addictions enterprise now actively and openly denigrate 12-step programs and residential treatment. They claim, in what is a classic example of psychological projection, that folks like me and my colleagues are ideologues and that they in their wisdom are great evidence based scientists. 

They are hauling in and spending many billions of tax dollars with little or no demonstration of any clean or sober citizen clients. They are building corrals of drugged up, stunned human beings forever dependent on the largess of these clever men and women. A dystopian and ugly scenario.

Note how much of their ‘research’ and funding comes from Big Pharma.

Harm Reduction has the microphone for the moment. May the return of what one great Canadian called ‘sweet reasonableness’ be upon us sooner than later.

Harm reduction and Insite are palliative.

They both spring from a deeply cynical and arrogant world view – You are an addict and you are hopeless. We will keep you “comfortable” while you continue to die.

This is a curious position considering the millions of men and women who admit that they are addicts and choose every day not to pick up their poison. We know thousands of such clean and sober citizens.

We as a body politic owe one another a chance at dignity. To offer less is not only costly, it is monstrous.