{"id":16393,"date":"2023-03-28T18:09:13","date_gmt":"2023-03-28T18:09:13","guid":{"rendered":"https:\/\/drugprevent.org.uk\/ppp\/?p=16393"},"modified":"2023-06-06T19:08:44","modified_gmt":"2023-06-06T19:08:44","slug":"daphne-bramham-harm-reduction-not-enough-to-end-b-c-overdose-crisis","status":"publish","type":"post","link":"https:\/\/drugprevent.org.uk\/ppp\/2023\/03\/daphne-bramham-harm-reduction-not-enough-to-end-b-c-overdose-crisis\/","title":{"rendered":"Daphne Bramham: Harm Reduction Not Enough To End B.C. Overdose Crisis"},"content":{"rendered":"

As in many other jurisdictions, there are no regulations in B.C. for addictions treatment centres, no standards for addictions services and no requirement for outcomes to be reported or monitored.<\/span><\/p>\n

They operate under the same legislation that regulates daycares and homes for the elderly, which means that only the facilities are inspected, not the programs or services within them.<\/span><\/p>\n

B.C. recovery homes don\u2019t have to be licensed, although they are required to be registered if they offer three or more beds. Some treatment facilities are accredited by third-party organizations. But, here\u2019s the kicker: \u201cMost homes are often short-lived business operations in rented housing,\u201d according to last week\u2019s report by the Death Review Panel set up to investigate British Columbia\u2019s epidemic of illicit-drug overdoses.<\/span><\/p>\n

The total amount British Columbia spends on treatment isn\u2019t clear, although it spends $90 million alone on methadone and other pharmaceutical replacement therapies for addicts each year. Beyond what the government spends, hundreds of thousands (if not millions) are spent by individuals, insurance companies or employers at private facilities that charge upwards of $30,000 to $40,000 a month for residential care. (The famous Betty Ford Center costs US$3,300 a week.)<\/span><\/p>\n

In an interview, the death panel\u2019s chair Michael Egilson said, \u201cSome supportive recovery homes, somebody may have just decided to set up on their own. The exact number and how they are dealing with treatment is hard to say.\u201d<\/span><\/p>\n

The panel recommends that by September 2019, British Columbia develop or revise regulations for all treatment facilities and services and set standards so that these facilities can be systematically evaluated and monitored.<\/span><\/p>\n

Egilson contends that what drove this recommendation is \u201can acute awareness that opioid-abuse disorders best practise is certainly different from some traditional abstinence models \u2026 Abstinence is not a desirable treatment. If a person relapses after a quick detox, there\u2019s a greater potential for overdose death.\u201d<\/span><\/p>\n

This is a harm-reduction model of replacing an illicit drug with a pharmaceutical one such as methadone, suboxone or even prescription heroin \u2014 \u201copioid agonist therapies.\u201d<\/span><\/p>\n

Egilson\u00a0referred specifically to Brandon Jansen, a 20-year-old who overdosed on a fentanyl-laced cocktail of illicit drugs in 2016 at the Sunshine Coast Health Centre in Powell River. At the coroner\u2019s inquest, where Egilson presided, evidence indicated that within the past three years, Jansen had spent time \u201cat a minimum of 11 detoxification centres, recovery homes and treatment centres.\u201d<\/span><\/p>\n

The fact that he relapsed was hardly unique \u2014 40 to 60 per cent of people receiving treatment do, according to the U.S. National Institute on Drug Abuse.<\/span><\/p>\n

The unspoken suggestion in the death panel\u2019s recommendation is that the government \u2014 along with individuals, their families, insurers and employers \u2014 is likely throwing money away because most addiction programs are based on Alcoholics Anonymous\u2019s 70-year-old, 12-step program.<\/span><\/p>\n

But the point is that we don\u2019t know. We don\u2019t have good data because its collection is not required. We don\u2019t even know what kind of snake oil some of these centres are selling because none of them is properly monitored.<\/span><\/p>\n

You can\u2019t help wonder why something as basic as ensuring that desperate people hoping to finally kick there habit are getting the help they need has been ignored.<\/span><\/p>\n

This is, after all, a city and a province that for nearly 20 years has been at the forefront of harm-reduction with needle exchange programs, safe injection sites, methadone and suboxone treatment programs, a prescription heroin program and, more recently, free naloxone kits, free-standing naloxone stations and training for first-responders and even teachers in how to use it as an antidote for fentanyl overdoses.<\/span><\/p>\n

We\u2019ve gone from crisis to crisis, each one sucking up incredible resources. Currently, a quarter of a million dollars a day goes into the Downtown Eastside alone for methadone treatment. This year, the B.C. government expects the number of British Columbians receiving replacement drug therapy to rise to 30,000 and then nearly double to 58,000 by 2020-21.<\/span><\/p>\n

In 2006 when Vancouver updated its four pillars approach, it noted that there were 8,319 British Columbians being treated with methadone.<\/span><\/p>\n

By 2020-21, the province also expects to be supplying 55,000 \u201cfree\u201d take-home naloxone kits, up from 45,000 this year.<\/span><\/p>\n

We keep hearing about an overdose crisis, but what we have is an addictions crisis. Solving it will require a lot more than simply reducing harm. The more intractable problems of poverty, homelessness and abuse that are often brought on by depression, despair and other untreated mental health issues need to be addressed.<\/span><\/p>\n

So, by all means, let\u2019s do what we can to stop the overdoses. Let\u2019s ensure that there is evidence-based treatment available.<\/span><\/p>\n

But let\u2019s quit pretending that until we deal with the root causes of addictions, harm reduction is little more than an increasingly expensive bandage.<\/span><\/p>\n

Source: Daphne Bramham: Harm reduction not enough to end B.C. overdose crisis | Vancouver Sun<\/a> April 2018<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

As in many other jurisdictions, there are no regulations in B.C. for addictions treatment centres, no standards for addictions services and no requirement for outcomes to be reported or monitored. They operate under the same legislation that regulates daycares and homes for the elderly, which means that only the facilities are inspected, not the programs […]<\/p>\n","protected":false},"author":12,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[67,36],"tags":[],"class_list":["post-16393","post","type-post","status-publish","format-standard","hentry","category-needle-exchange","category-treatment-addiction"],"_links":{"self":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/16393","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/comments?post=16393"}],"version-history":[{"count":0,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/16393\/revisions"}],"wp:attachment":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/media?parent=16393"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/categories?post=16393"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/tags?post=16393"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}