Four Pillars plan totters on two: harm reduction and police

Among the many problems with Vancouver's failing Four Pillars approach to the grotesque addiction problems in the Downtown Eastside is that it has spawned the Not-in-Anybody's-Backyard movement.

It now seems impossible for municipalities like Richmond, Coquitlam, Gibsons, or Keremeos to even consider proposals for abstinence-based treatment centres without NIABY proponents raising red herrings such as Vancouver Mayor Sam Sullivan's support for providing free heroin to addicts or Senator Larry Campbell's support for reforming drug laws.

They even question the fact addiction is a disease, not a choice.

Small wonder.

The Four Pillars plan totters on only two -- harm reduction (which includes the safe injection site, the ever growing distribution of free needles, methadone and possibly free heroin) and the best enforcement Vancouver police can muster without completely abandoning the rest of the city.

It hasn't made a dent in the nightmarish scene at Main and Hastings or the lives of the hundreds of addicts who congregate there.

No one wants that replicated in their community.

However, that begs the issue of treatment.

As this week's series in The Vancouver Sun makes clear, alcoholism alone affects thousands of Canadians. It also makes it clear that tens of thousands of Canadians have recovered with treatment. And while the series focused on alcoholism, clinicians don't differentiate between them and drug addicts. They are unequivocal.

Addiction is a neurological disorder for which the only cure is abstinence and that means recovery is a process that takes years and often many attempts.

"There is no place for controlled substance abuse in addiction. Period," said Dr. Graeme Cunningham, associate clinical professor of psychiatry and director of the addiction division of an Ontario health centre.

For years, Dr. Douglas Coleman along with other board-certified addictions physicians have been saying the same thing in Vancouver. But they're rarely heard above the din of harm-reduction proponents and others who suggest drugs aren't addictive, rather a symptom of poor living conditions or some other disorder.

Medical experts like Coleman define addiction as a war between two parts of the brain. The forebrain, which controls our intellectual or rational understanding, is not able to keep the mid-brain, the emotional centre, in check.

Addicts are, in Coleman's words, people who continue to use drugs or alcohol despite knowing the consequences are episodes of loss of control and an ongoing preoccupation with getting that next drink or fix.

They drink or use drugs knowing full well it will impair their judgment.

That's what they want.

As Coleman says, "There's not a respectable addict in this country who would say, 'No, I think I've had enough.'"

Abstinence is the only proven cure, which is why Alcoholics Anonymous, Narcotics Anonymous and Turning Point, which is proposing a 32-bed facility in Richmond, insist on it.

Each week across Metro Vancouver, there are 700 Alcoholics Anonymous and Narcotics Anonymous meetings. That's 100 meetings a day in different neighbourhoods attended by doctors, lawyers, clerics, truck drivers, airline pilots, journalists, and every other kind of person you can imagine.

That's why it makes sense to not put recovery services in the midst of Vancouver's chaotic, drug market.

It's like holding Weight Watchers' meetings next door to a chocolate shop.

Harm-reducers have all but convinced us that some people can't be cured because there is too much wrong with them -- mental illness piled upon multiple addictions.
Email to a friendEmail to a friendPrinter friendlyPrinter friendly

So, who wants them in their neighbourhood?

But Coleman contends everyone has the potential to abstain and recover. To suggest harm recovery is the best we can do, he says, is a death sentence.

Even NIABYs don't oppose treatment. They simply want it far away from them, which has proved an attractive idea to urban politicians, especially Vancouver-Burrard MLA Lorne Mayencourt.

His non-profit, New Hope Recovery Society has taken over Baldy Hughes, an abandoned U.S. military base 35 km from Prince George. Based on the village model of San Patrignano, Italy, and the principle of abstinence, the first recovering addicts moved in earlier this month.

Last spring, The Sun's Jonathan Fowlie visited San Patrignano where addicts spend an average of three to four years recovering.

One resident told him that when she went home for a short visit, "It was strange. I felt like a Martian. I felt it was a world that wasn't mine anymore."

That's why addictions specialists refer to wilderness camps as "the Greyhound cure." It doesn't fully address the reasons addicts craved impairment in the first place.

So, what we're left with is this:

We can maintain the status quo, pouring millions of dollars into the Downtown Eastside and pretending that two pillars are four.

We can pack addicts off to the hinterlands and hope they don't come back as Martians.

Or, we can accept the medical evidence that recovery is a slow, hard process that's made easier if people get needed services in their own communities where, unimpaired, they can rebuild and resume their lives.

source: Daphne Bramham, Vancouver Sun
Published: Friday, December 21, 2007
© The Vancouver Sun 2007