Drug report says programs lacking for long-term recovery of addicts
Former user suggests too few people are told getting clean is an option
Through all the harm-reduction and outreach services that kept Josh McDearmid alive during three grim years of drinking and using cocaine on Downtown Eastside streets, he says no one mentioned recovery to him — that there was the opportunity for him to get better.
“When I was out on the streets using my resources — going to shelters, food lineups, youth resource centres that see me messed up and intoxicated every day — not once did they mention recovery to me,” said the 24-year-old Cree man who grew up in B.C.’s foster care system. “I had accepted my death down there.”
But in December 2016, when McDearmid had “hit bottom” living in a tent city on Hastings Street, he got a Facebook message from a high school friend who was in recovery, suggesting the young man try it as well.
He has been clean ever since. “People need to get told about recovery. It is an option out there. We just need to bring up the awareness,” said McDearmid, speaking Wednesday at the release of a new report by the B.C. Centre on Substance Use.
The provincial health system has responded to the overdose epidemic with important harm-reduction measures, but it has failed to create sufficient long-term recovery services to truly curb drug addiction, says the document, entitled The Path Forward.
“Strengthening recovery services in B.C. can significantly reduce population harms, yield financial savings and, most importantly, improve the lives of individuals, families and communities,” says the 44-page report by the centre, which develops and studies evidencebased approaches to substance use.
People with serious addictions are often offered such options as detox and pharmaceutical replacement drugs, but these on their own are unlikely to bring about “sustained remission and long-term recovery,” the report says.
“As with other complex chronic medical conditions, such as heart disease and diabetes, continuing self-care for people with substance use disorders is critical,” it continues.
It recommends more community-based recovery-management services in which people who have beaten their addiction could provide coaching to those pursuing recovery.
These services could be in community centres, high schools, universities, job sites, supported housing, etc.
The authors — Dr. Evan Wood, the centre’s director, and Marshall Smith, its senior adviser for recovery services — hope the report will help influence everyone from service providers to corporate boardrooms to city halls to the year-old NDP government.
Judy Darcy, B.C.’s first minister of mental health and addictions, who plans to announce a revamping of the provincial drug treatment system this fall, was briefed earlier on the centre’s report.
“I think there is huge alignment and support there,” Wood said when asked if government will consider the report’s recommendations.
In an interview last week, Darcy said she has heard from people frustrated by B.C.’s convoluted system.
They complain about a lack of services, long waiting lists and people repeatedly being turned away because they haven’t gone to the right place for help.
“When you are talking about mental health and addictions, you are kind of on your own navigating that system,” Darcy said.
“These experiences left (people) frustrated, overwhelmed, angry and sometimes desperate. These conversations are painful, emotional, intense. They deepen our resolve ... to fix the gaps in our system.”
Her ministry has made some changes during its first year in existence, but Darcy admits she has more work to do.
She has set out a six-point plan — improving harm reduction, ending stigmas around addiction, providing more recovery services and social services such as housing and poverty reduction, addressing the underlying risk factors for addiction, and stamping out the illegal drug supply — to be implemented in the future, but not until after funding is earmarked in the February 2019 budget.
“We are doing this for the people who have been let down in the past and we are doing it for the people who have fallen through the cracks,” she said.
The new report calls on Darcy’s ministry to create “a responsive system of addiction care, where patients and families only need to ask for help once, and are able to get support right away, as they do with other illnesses.” The report’s recommendations include:
More timely referrals from entry-level services like detox to recovery programs.
Improved funding for vulnerable populations to attend treatment.
More services for Indigenous people, youth and women, including mother and baby programs.
Better services inside jails and for those on probation.
Workplace programs to help employers recognize substance abuse.
Stamping out unsafe and illegal rooming homes pretending to be recovery centres.
Promoting acceptance and tolerance through anti-stigma campaigns.
The report highlights several types of treatment that were identified by former users as models that have worked well. These include:
Residential programs for people who have struggled to quit.
Recovery or transitional housing where people can move after completing residential treatment, and which typically helps them avoid relapsing, find a job, and prepare to live independently again.
Non-residential 12-step support meetings.
Helping substance users get treatment is not just the moral thing to do, the report says, it also benefits everyone.
Surveys of people in recovery show that, after leaving their addictions, they have far less contact with the health and justice systems, and typically have a job, stable housing and better family relations.
We are doing this for the people who have been let down in the past and we are doing it for the people who have fallen through the cracks.