DRUG DEBATE REDUX

A Research Trial Would Benefit Both The Individuals And The Community
By Helping Get Addicts Off Illegal Drugs

The proposed research trial named CAST -- for chronic addiction
substitution treatment -- has reignited a debate about how to deal
with Vancouver's drug problem. And a big problem it is.

Studies indicate more than 33,000 British Columbians are dependent on
illicit drugs. Property thefts, assaults, street prostitution,
aggressive panhandling, dumpster diving, shoplifting and homelessness
are, in many cases, directly related to people with chronic
addictions desperately trying to find money to buy illegal drugs.

More than 140,000 property crimes were reported in Greater Vancouver
during 2005. Drug offences have increased by 63 percent. There are
800 chronic offenders who are arrested more than five times per year.
Many of these admit to committing between five to 15 crimes per day
to fund their drug addiction.

In Vancouver's Downtown Eastside, the impact of addictive drug use is
plain to see. The area has the highest HIV infection rate in North
America, affecting almost 30 per cent of the local population, mainly women.

Use of drugs like cocaine, crack cocaine and methamphetamine has long
been recognized as a driver of the HIV epidemic. These drugs are also
associated with heightened violence, crime and public disorder.

On Feb. 26, Vancouver Mayor Sam Sullivan and an impressive group of
doctors, concerned parents, ex-drug users, enforcement officers,
residents, business people from the Downtown Eastside and politicians
from across the political spectrum came together to launch Inner
Change, the non-profit society that will drive the CAST research trial.

CAST would work with addicted people to substitute their use of
illegal street drugs with legally available, orally administered
prescription medications. The CAST trial rejects the use of needles
and illegal drugs. The short-term goal is to help addicted people
stabilize their lives, identify any underlying mental health issues,
remove the need for criminal activity to finance their drug habits
and reduce their impact on the surrounding community. The eventual
goal is to get them off drugs completely -- abstinence.

Some people believe we should simply crack down on the problem with
more enforcement.

The truth is we already spend 73 per cent of federal drug strategy
money on enforcement, despite a lack of any scientific evidence to
support this approach and little evaluation of the effects of this investment.

Another 14 per cent is spent on treatment, almost exclusively
abstinence-based. In spite of the impression created by all the media
discussion, only three per cent of federal drug strategy money goes
to harm-reduction programs.

Some people argue the only way to help addicted people is to get them
into abstinence-based programs. Again, the facts suggest otherwise.

Approximately 75 per cent of addicted people do not respond in the
long term to abstinence-based treatment. Only about 15 per cent
manage to stay clean for the long-term after-treatment. The other 10
per cent manage to become abstinent all on their own.

While many of us simply want the crime and the open drug market to go
away, Phoenix Beck reminds us of what is really at stake. Phoenix is
a young woman, now 25, who spoke at the Inner Change launch with
disarming honesty and frankness. She told us she was 15 when she
first tried smoking crystal meth -- she had no idea what it was. She
lived on the edge of the Downtown Eastside for the next five years,
spiraling down into a bleak life.

But Phoenix is a survivor. She decided to change and found a friend
who gave her Adderall, a prescription stimulant. It is ironic that
Phoenix had to get Adderall "illegally" to get off street drugs. She
took the Adderall for just one week while her body adjusted to coming
off the street drugs. Phoenix has made it back.

We as a society don't seem to have a problem with substitution
treatment for people with decent homes and stable lives who are
trying to deal with an addiction: Smokers can use a patch for
nicotine replacement. Yet we expect people addicted to street drugs,
often homeless with no stable source of income, to be able to quit
hard drugs without medication.

Inner Change is young, and CAST is still in the planning stage. There
are many details to work out. We need to put our heads down and work
with the talented and knowledgeable group of professionals who have
come together to drive this concept to reality.

As Dr. John Blatherwick said at a recent workshop: "There are many
questions yet to be answered, but Mayor Sullivan has given us a huge
opportunity here to create a program that could profoundly impact
both addicted people and the communities they live in."

Getting people off illegal drugs is still the goal; CAST is another
option, another tool to help addicted people get there.

Lois Johnson is executive director of Inner Change.