Thank You

I’d like to start off by thanking all those who have taken their time to read this blog, and making such insightful and valuable comments. It’s amazing to see how many people are affect by this issue and how much people have to say about it.

As the semester comes to an end, it’s time to put a close on the blog- but do not worry, my interest in this topic has not ended just because the semester is over. I will continue to catch the latest news on the drug policies in Vancouver, and try to broaden my knowledge on the organizations out there in support of solving this social problem.

Thanks again everyone for your continued support and dedication!

Kelly

How can we increase the effectiveness of prevention?

As I stated in an earlier post (The Four Pillars Drug Strategy), I believe that prevention is the most effective way to absolve drug addiction. This is probably also the most difficult aspect to implement, as those who have not experienced the consequences of drug addiction often do not know how strong addiction can be, and how it can even affect those who think they are invincible. 

 So how do you convince someone not to do drugs when he or she thinks that it’s not as harmless as it looks?

In our Social Innovation class we’ve been instructed to come up with our own novel solution. The best solution I can think of, is to simply show them. Not only through TV shows, pictures, books, pamphlets, or videos, but actually show them the real thing. I’m talking about taking them to the Downtown Eastside to firsthandedly witness just how harmful drugs are. Currently educators target people early, which I believe is the right approach. People are most easily influenced at younger ages, but it is also the young age that holds many programs back from such a risky approach. Educating the young by exposing them to a risky environment could create controversy; I cannot imagine many parents being happy if they heard that schools began taking their children to the worst streets in Vancouver. However, some people do not believe it until they see it, which I believe is necessary in this situation. This program could increase the safety of this program by incorporating the police force. According to the Four Pillars website, The Vancouver Police Department’s drug policy strategy aims “to reduce crime, fear of crime, and street disorder while protecting the vulnerable and preserving and protecting life.” The VPD often target drug traffickers and producers, not those who are simply minding their own business. If the police force was integrated with this education program, children would be able to attain more awareness while being protected by a public safety force.

An effective education program would incorporate the above, as well as other prevention tactics. The program would also target children who live in low-income families, and connect them with successful entrepreneurs who have once been in the same position. This will give those children some hope and confidence that they too, can overcome poverty in order to succeed in society. I think this aspect is necessary because it shows both sides- what can happen if you do give in to drugs, and what can happen if you run into the other direction.

I think that this idea is different from current programs as many of them are afraid to expose children to dangerous situations. But many aspects of life are dangerous, and we cannot shield them from these dangers and hope at the same time that they will be capable of making the right decision when reality strikes. Yes, there is already education out there trying to convey the same message, but what I think we need to do is just take that extra step to really make sure that children get the point- no matter how strong  and invincible you think you are, addiction is stronger.

It is not about providing more education, but more effective education. By showing children at an early age the reality of addiction, one can hope that it makes them steer far, far away from it.

Long term drug treatment

I read an interesting article in The Province the other day and thought I would shed some thoughts on it. Ethan Baron, the author of the article, had previously written a column which stated that, “addicts who collect welfare and steal to support their habits should be forced into long-term rehabilitation.”

This concept poses that addicts who are convicted of crimes can choose between going to jail or going to long-term rehab, in hopes that once the addicts are presented with the opportunity of treatment, they will take it. This of course, is a conditional sentence and the decision would ultimately be up to the judge. Where would this facility be? Suggestions have been made about incorporating the model into the already existing long-term care centre in Burnaby (at the Burnaby Centre for Mental Health and Addictions,) or at Riverview Hospital in Coquitlam. How can we afford this? While the cost to provide facilities and treatment would be immense, these costs would be offset by the reduction in welfare collection, theft, and emergency room visits.

This column has brought on much debate as to whether or not it is an effective solution. Those who support the idea say that forcing treatment can work, and may be necessary as drug addicts are often incapable of making rational decisions. Since addicts have no control over their addictions, and the system has no power over the addicts, forcing them into long-term treatment may be the only to guarantee that they stay clean.

Those who are against the idea believe that addicts do not need to be forced into treatment. They believe that the problem is that the opportunity to clean up is currently not realistic and available; yet if the appropriate resources are provided, then many addicts would be interested and would probably admit themselves. Those who argue against the idea of forced long-term treatment also voice concerns about how this concept can violate civil rights, that addicts have the right to decide how they spend their money. Further arguments state that more focus should be put on prevention, so that this problem can be attacked at its roots.

While I believe that prevention is the best solution for this problem, I do not think that we should give up on those who have gotten caught in the spiral just because they made the mistake of trying a drug “just this once.” If we only focused on prevention, we would be giving up on those who are suffering, probably the most they’ve suffered in their entire lives. It would be unfair to leave those victims behind, just because they do not have the rationality or resources to go in the right direction.

I think that the long-term treatment would be a good idea. Many current treatment offer short term treatment, while providing some sort or mentorship or sponsorship afterward. Long-term treatment would increase the education, support, and counselling for the addict which would in turn increase the chances of the addict closing that chapter in his or her life. If they are going to be put in jail anyway, why not try to help them instead of shutting them out of society?

The Four Pillars Strategy

The Four Pillars Drug Strategy is a framework created by the City of Vancouver in order to reduce drug related harm in Vancouver. It collates a group of over 60 local businesses, and governnment and non-government organizations. Here is a copy of the original strategy called Framework for Action (2001.)

The Four Pillars of the drug strategy are listed and described below (Source: http://vancouver.ca/fourpillars/fs_treatment.htm).

1) Prevention: strategies and interventions that help prevent harmful use of tobacco, alcohol, and drugs. This pillar aims to reduce harm, delay onset of first substance abuse, reduce incidence, and improve public health, safety, and order.

2) Treatment: a range of interventions and support programs that encourage addicts to make healthier decisions about their lives. This pillar works to decrease preventable deaths and injuries, while improving social integration.

3) Harm Reduction: strategy to reduce the harm to individuals and communities from the sale and use of substances. This pillar focuses on the harm caused by using, rather than the act of using. This pillar focuses on achievable terms and recognizes that abstinence may not be a realistic goal.

4) Enforcement: strategy that recognizes the need for peace, public order, and safety in Vancouver. This pillar integrates all other pillars as policing alone is not the solution.

The framework provides various solutions that comply with each of the four pillars. It began its first implementation in the 1990s in Switzerland and Germany. Programs in these locations have resulted in a dramatic reduction in the number of users consuming on the street, as well as a reduction in overdose deaths and infections.

I will post more on this topic after our class meets with Donald MacPherson, the Drug Policy Coordinator of the Four Pillars Drug Strategy. Stay tuned!

Is Drug Addiction a Personal or a Social Problem?

While drug addiction can affect many people and families around the world, some would claim that drug addiction is more of a personal issue rather than a social one. This is a logical argument; after all, drug use is a personal choice and the consequences of usage is usually the responsibilty of the drug user.

So when is it considered a social problem, or can it even be considered one? From our Social Innovation class, a social problem is one that:

• is widespread
• gives off the preception that something is wrong (experts and public)
• threatens values
• requires action- change is possible (Manning, N. 1998)
• An alledged solution that is incompatible with the values of a significant number of people who agree that action is needed to alter the situation (Rubington & Weinberg, 1989:4)

Let’s start with the first point. To me, drug addiction is widespread. Not only in Vancouver, but in America, and the rest of the world. I think the reason why one would think that drug addiction is not widespread is because he or she does not often hear of drug addicitons halfway around the world. Furthermore, different cultures determine the different ways people and their society deals with drug addiction, which could mean that people hide it more in other places of the world. No matter where you go though, drug addiction exists; isn’t that widespread enough? Not only that, but the drug related violence and crime that results from the need to feed an addiction affects society as a whole. More resources must be directed to mitigate these problems which takes away some of the resources needed for other problems.

I certainly hope that drug addiction gives off the perception that something is wrong. If nobody had the perception that something was wrong, there would not be treatment centres or support groups available.  There would not be doctors and researchers trying to find solutions, or thousands of websites promoting actions to mediate the problem.

Drug addiction threatens values of many; those people could be family members or friends of the addict, members of the community that are in the proximity of drug use, educators, doctors, business people, and anyone who is around or involved in drug use. Addiction takes away the ability to live up to values, whether it is because the drug user can no longer think rationally, or because the close members of the drug user must go against their own values to enable someone they love and care about.

Since drug addiction is seen as a problem, the next logical thing to do is to look for actions to not only decrease the number of addicts but also the amount of homelessness, violence, and crime. Action is needed in order to decrease the chances of others in the community being at risk of the consequences of one’s addiction. To change the situation is a challenge- but possible.

To me, drug addiction begins as a personal problem. It is stemmed from various personal problems, but begins to transform into a social problem when it affects the community. It puts the addict and those around him or her at risk, whether it is a risk of drugs, violence, or crime. Finding novel solutions to this problem will not only help the person who is involved in the addiciton, but the general public, because one way or another, we are all affected.

Root Causes of Addiction

It is often difficult to pinpoint the root cause(s) of addiction. In my Social Innovation class, we learned that people often identify causes which are actually just symptoms. By solving these these symptoms, however, often do not solve the actual problem. The process of distinguishing symptoms from causes can be a difficult one. In relation to drug abuse in Vancouver, people often point to many symptoms:

• The availablity of drugs
• The lack of post trauma counselling programs
• The unrealistic time pressures of treatment centres
• Lack of education on drug prevention

The list of symptoms go on; however, when taking a step back, what is the actual problem here? Majority of drug addictions are due to trauma and mental illnesses. Does this mean that society doesn’t have proper resources to deal with Post Traumatic Stress Syndrome (PTSS)? Or is it that we do not properly classify those who suffer from PTSS and other mental illnesses? This problem can also be stemmed from the increasing peer pressures at school, or a lack of drug prevention programs.

It is hard to draw the line that distinguishes causes from symptoms of drug addiction. In my opinion, there are several factors that lead to the many symptoms. In order to identify them one would really have to break down the symptoms. The three that stand out most in my mind are mental illness, trauma, and early exposure to risks.

Early exposure to risks could be due to the fact that many children are not properly educated on the consequences of drugs, or to the fact that many children live in underprivledged areas where they have no other exposures. This could be led by poverty, which could be one of the underlying factors of addiction.

Mental illness and trauma could be due to the fact that some areas do not have the proper resources to diagnose these problems, or the proper resources to treat them. This could lead to a feedback loop where it feeds the addiction which then in turn feeds the illnesses. Could inadequate health care be the root of this problem?

These are only some ideas as to what the root cause of drug addiction may be. What I am listing could be symptoms as well, but that I cannot find out until I explore further. Through researching for solutions I am hoping to get a little more enlightenment on the causes as well.

Eliminating Drug Associated Memories

When dealing with a drug addiction, many have to consider psychological addiction as well as the physical one. While many treatment programs (such as methadone clinics) often tackle the physical side of things, many addicts are often still stuck with the pyschological effects long after sobriety. Particular environments trigger memories which associate the addict with the drug, and the feeling of need returns. This can be difficult for the addict and unfortunately in many cases can lead them to relapse. I found an interesting concept in a recent article published by Physorg.com (April 2009), which touches upon how deal with these memories. The answer? Take them away.

Previous studies done have found an experimental drug called CDPPB which, when tested, proved to ease the power of certain memories. Research in this study was done on rats, through which researchers would inject the rats with cocaine in certain environments (I am not quite sure how I feel about the animal testing here, but that is another blog altogether!) Through observation the researchers found that after the injections the rats developed a preference for those environments when a placebo was given. After injecting the rats with the experimental drug CDPPB, this preference was observed to decrease. This process is defined as extinction learning, where new associations are created, rather than retrieving the old ones.

The results of this experiment were presented in hopes of being able to apply it in the human world, possibly in conjunction with exposure therapy. There were no details in the article about possible side effects and whether this solution is permanent.

I find this an interesting article and it really makes me think about whether this really works, and whether it would be accepted within society. While I can see the potential effectiveness of this drug I am hesitant about whether it is ethical. If this drug were to get into the wrong hands, it could be disasterous. However, if it is distributed in a controlled, structured environment, it may have the potential to ease the recovery process for many drug addicts.

Key Facts

Provided below is a reference to the various drugs available out there (Source: From Grief to Action). This is only a brief (very brief) desciption of each drug, and there are more complexities than listed below. For more information, visit www.ftga.ca.

Alcohol

What it is: a depressant which slows down parts of the brain and nervous system

Effects: reduced concentration; slurred speech; blurred vision; lack of coordination and judgement; increased aggression; possible brain damage; possible overdose/unconsciousness; liver damage; heart/blood disorders; stomach inflammation; impotence; menstrual irregularity

Cannabis (marijuana, weed, pot, dope, grass, ganja, hashish)

What it is: a short name for the hemp plant Cannabis Sativa; what causes the high is the chemical called THC (tetrahydrocannabinol)

Effects: a feeling of well-being and lethargy; tendency to talk and laugh more; reddening of the eyes; impaired coordination; reduced concentration; lack of perception of time, sound, and colour; feelings of excitement, anxiety, paranoia, and confusion

Cocaine (cocaine hydrochloride, coke, blow, snow, flake)

What it is: a central nervous system stimulant, derived from leaves of coco plants; floods the brain with dopamine, a natural occuring neurotransmitter

Effects: feeling of euphoria and wellbeing; increased alertness and energy; increased confidence; reduced appetite; increased heart rate and body temperature; enlarged pupils; increased aggressive behaviour; inability to judge risks; headaches; dizziness; restlessness; loss of concentration; lack of motivation; heart pain; heart attack; nose bleeds; cocaine psychosis (hyperactivity, delusions)

Ecstasy (MDMA-MetheleneDioxyMethAmphetamine, XTC, MDM, E, X)

What it is: a synthetic drug that stimulates the central nervous system, often sold  in tablet or powder form

Effects: increased feelings of self-confidence and well being; rise in blood pressure and body temperature; increased pulse rate; jaw clenching; teeth grinding; sweating; dehydration; nausea; anxiety; hallucinations; irrational behaviour; vomitting; convulsions; loss of appetite, insomnia, depression, muscle aches, loss of concentration

Heroin (smack, horse, dope, rocks, shit, down, gear)

What it is: a central nervous system depressant which comes from the opium poppy; usually comes in powder form

Effects: dull perceptions of pain and fear; slow breathing; reduced body temperature; nausea; vommitting; itching; constipation; damaged veins, heart and lungs; irregular menstruation; infertility; impotence

Inhalants (glues, aerosols, liquid paper thinners, butane gas, nitrous oxide, gasoline)

What it is: solvents that depress the central nervous system

Effects: feelings of excitement and relaxation; loss of coordination; disorientation; increased fear; blackouts; mild hallucinations

Methadone

What it is: a depressant drug that slows brain or central nervous system activity; does not produce a high, but used to help stabilize those who are dependent on heroin-like opiates

Effects: sweating; constipation; lowered sex drive; aching muscles and joints; itchy skin; suppression of appetite; stomach pain; nausea; vommitting

Methamphetamine (meth, crystal, jib, speed, ice, crank, glass, tweak, sketch, tina, yaba, shabu)

What it is: a synthetic central nervous system stimulant, usually sold in forms of tablets, capsules, chunks, powders, crystals, and glass shards

Effects: there are many effects of meth, which could not all be listed here, but some effects are irritability; tooth grinding; insomnia; restlessness; anxiety; panic; headache; jaw clenching; decreased fatigue; extreme weightloss; seizures; respiratory depression; convulsions; kidney and heart failure; confusion; paranoia; violence; memory loss

Psychedelics (hallucinogens such as magic mushrooms, peyote cactus, LSD/acid)

What it is: a group of drugs that can change a person’s perception, which makes them see or hear things that do not exist

Effects: changes in thought, sense of time and mood; anxiety; fear; loss of control; inability to concentrate; abnormally rapid heart beat; raised blood pressure; depression; psychosis

Keeping the Door Open: Dialogues on Drug Use

Keeping the Door Open (KDO) brings together different dialogues to bring more awareness and discussion to various substance abuse problems. It is basically a site that provides different resources if one was looking for more information or was looking to discuss different issues like self-injection sites and criminalization. Different speakers (locally, nationally, and internationally) are brought to different venues in order to engage others, by sharing their own stories and insights. The site brings together people from different spectrums including drug users, their friends and family, police officers, elected officials, business people, and the local community.

I found the site interesting as they bring up a broad range of issues to discuss. I particularly like the fact that it recognizes the complexity of addiction and its (often) attachment to mental illnesses and trauma. The event that caught my eye the most was the one held most recently in March/April of 2008- Rethinking Treatment: Recognising and Responding to the Spectrum of Substance Use. This event discusses the fact treatment is currently being provided with “enormous and unrealistic time pressures by inadequately trained staff and does not follow established best practices.” I believe that in fact treatment is provided under unrealistic time pressures and many do not recognize (or understand) that the battle with addiction is one that lasts a lifetime.

It is easy to present facts about addiction but it’s another story when trying to engage others in the process of analyzing how to make it more effective. This is a good site for those who are willing to talk about the issues and are ready to begin creating innovative ways of solving the problem.

Onsite: Insite’s detox floor

Onsite is an addition to Insite where the injection users can turn to should they ever decide to quit using. It is located on the second floor of the same building, and consists of 12 detoxification rooms (each with its own bathroom). The facility also includes a common room and kitchen, and is staffed with nurses, doctors, and counsellors for their various services. Onsite incorporates a methadone program and enforces standard rules; like any other detox facility, drug use is prohibited and can result in withdrawal from the program.

I feel that the addiction of Onsite to Insite reinforces the goals of this organization. As I have stated in one of my previous posts (CBC’s Fifth Estate: “Staying Alive”), the point of Insite is not to encourage or increase drug use, but to ensure that the drug users are safe and directed away from crime and disease. Those who are looking for a way out can finally be a step closer to it-or in this case, a flight of stairs closer. In addition, up another flight of stairs is a temporary shelter which houses 18 rooms, for those who need a night away from the madness on the streets, or have nowhere else to go. When I discovered this, I questioned whether many drug users overstay their welcome at Onsite; however, I quickly answered my own question when I re-evaluated the power of addiction. I feel that many users probably do not stay long; instead they are probably already looking for the next fix first thing in the morning.

I am not sure whether these resources are adequate for the number of users out there; 12 detox beds and 18 temporary shelter beds seem like a small number, but you have to start somewhere. If all of those detox rooms are filled, there is potential that there are 12 less users on the street, and therefore potential of getting 12 users off the streets and off the drugs (though this may be unlikely because of relapse, one cannot help but think of the best case senario.) Even if half of those users stayed clean, it is a start. If you don’t offer anything at all, then nothing is done (sounds redundant, but true). And sometimes the power of suggestion goes a long way.