Help people recover, addictions report urges
No one should be written off as being “beyond help” when it comes to addictions, says a new research paper by the B.C. Centre on Substance Use.
The paper, Strategies to Strengthen Recovery in British Columbia, says it is time for authorities to move beyond focusing solely on harm reduction and embrace a full system of care that includes the possibility of people recovering from addictions.
“Stopping at harm reduction’s water’s edge is not going to get us where we need to go,” said Marshall Smith, the centre’s senior adviser on recovery initiatives.
“We need to invest research and resources in developing out and enhancing a recovery orientated system of care and building a system of care that spans from harm reduction right through to abstinence-based programs, systems and services,” said Smith, who said he knows from his own experience, as a homeless alcoholic hooked on cocaine and methamphetamine, that recovery is possible.
Individuals with addiction are often devalued and written off by society, the paper says.
“This is costly, unethical and wrong. Research has clearly demonstrated that long-term recovery from substance-use disorders and other addictions is not only possible, but is an attainable and sustainable reality for many individuals regardless of the severity and duration of their addiction,” the paper says.
It notes that people in recovery and the broader recovery community often face discrimination and social stigma, which many describe “as being reduced to past diagnosis, stereotype or risk score.”
The report calls for improved addiction-recovery services that would provide equitable access to long-term, quality care, regardless of someone’s ability to pay.
Provincial health policies for dealing with addictions should be broadened to include recovery orientated, abstinence-based interventions and supports, the paper says. Such a move would mark a dramatic shift from a provincial system that has focused more on harm-reduction initiatives, such as providing clean needles and take-home naloxone, which counteracts the effects of opioid overdose.
“While countless lives have been saved through these essential programs and supports, the emphasis on public-health and harm-reduction programming has meant that resources and attention aimed at building an effective and co-ordinated addiction-care system have traditionally been lacking,” says the paper, authored by Smith and centre director Dr. Evan Wood. “Research has clearly demonstrated that longterm recovery from substanceuse disorders and other addictions is not only possible, but it is an attainable and sustainable reality for many individuals, regardless of the severity and duration of their addiction.”
More than 18 months of research and consultation, including with those who have experienced recovery, went into the paper. While it is critically important to provide effective acute treatment services, such as withdrawal-management programs, it is also necessary to develop and strengthen long-term, recovery orientated services to support people who want to overcome addiction, it says.
“We have, for a long time in British Columbia, had a fairly singular focus on reducing harm and that needs to continue and . . . lots of lives have been saved as a result of that,” Smith said, adding that the authors are not suggesting money should be diverted from those initiatives. “[We are advocating] only that recovery and getting well and getting people into an equitable and accessible system of care is needed and needs significant investment.”
According to the paper, recovery-orientated systems of care could include: recovery community centres, recovery high schools, collegiate recovery programs, recovery workplaces and recovery supportive housing, among other services. “Recovery community centres in particular can serve an important role in a recovery-oriented system of care by serving as a low-barrier, central location in the community where individuals can access peerled recovery support services, participate in education and training programs, and attend a variety of recovery-oriented mutual support group meetings,” it says.
The authors concluded that recovery residences are “an important component of the continuum of care,” but said they are often undervalued or overlooked.
There is not a single municipality in the capital region whose bylaws allow for recovery houses, Smith said.
The paper makes several recommendations, including: • Establishing a template for municipalities for the zoning and licensing of recovery homes and treatment centres; • Supporting strategies to increase provincial authority to close unlicensed or illegal treatment centres; • Exploring the development and implementation of a mandatory certificate program for recovery residence operators; • Supporting the establishment of recovery community centres in suburban areas; • Supporting the establishment of collegiate recovery programs; • Exploring B.C.’s first recovery coaching centre.