Shame if we fail to pursue a treatment system that gives real hope to addicts
By Trish Walsh, The Province
What would you say if the government spent approximately 11 million of your tax dollars to prove a new treatment helped heroin addicts out of their death spiral -- and then let the report sit on the shelf?
As outraged as we may be, think of how an addict in the program may feel.
Hope is on the horizon and one day you show up for treatment and the doors are closed. This scenario is playing itself out in Vancouver right now.
Three months ago, University of B.C. and St. Paul's Hospital researchers released the long-awaited results of the North American Opiate Medication Initiative (NAOMI).
The research trials took 251 chronic drug addicts in Vancouver and Montreal and introduced them to a bold, new heroin-maintenance and substitution treatment over a three-year period. All participants had not benefitted from traditional treatments numerous times in the past. Many suffered from mental illness.
The results were revolutionary. Crime and illicit drug use went down -- health outcomes, quality of life and employment went up. Illicit heroin use fell by almost 70 per cent among those in the study; the number of days of illegal activity and the amount spent on drugs both decreased by almost half. The trial was also highly cost effective; the cost to run the program was approximately $20 a day per addict, or $7,500 per year, which is a bargain compared to the estimated $55,000 an untreated addict costs the health-care and criminal-justice systems.
Instead of engaging in prostitution and breaking into cars, addicts spent time with care providers receiving psychological and social support and a limited daily supply of heroin. About 20 per cent of them were prescribed a legal substitute pain medication called Dilaudid instead of heroin -- but were not told. Amazingly, these addicts did not notice the difference.
Normally, we would think health agencies and government would be racing to fully implement findings such as these. Not in this case.
This highly successful trial ended in June 2008, and the program stopped.
With the exception of some methadone treatment, many addicts have been left to relapse into the back alleys and waiting arms of organized crime in our Downtown Eastside.
In the coming weeks, the Legislature will consider its last provincial budget. The researchers who gave us this breakthrough of hope will be waiting. The addicts who benefited from their compassion and discovery will be waiting, too.
One of the many things our elected officials will also consider in the new budget "sweepstakes" is a proposal to create an international research treatment centre at UBC for addiction and concurrent disorders as part of a comprehensive 10-year mental-health plan.
In addition to taking NAOMI to the next step with promising substitution treatment, the UBC centre will be able to leverage private-sector investment and corporate goodwill and attract the best minds in the world to one of the worst parts of our country. It is practical, real solutions like this that can bring the goals of Operation Phoenix to life.
If this legislature fails to act on its "last chance budget," we will be left with troubling questions.
After decades of searching for solutions in the Downtown Eastside, why do we turn our backs on something that finally looks like it could really help?
Has Vancouver lost its appetite to be at the cutting edge of harm reduction and new treatment for drug addiction and mental illness? Why innovate if the status quo prevails?
Trish Walsh is executive director of the Inner Change Foundation, a non-profit society focused on promoting innovative drug treatment research -- including substitution treatment for chronic addicts.
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