GETTING TO THE ROOTS OF ADDICTION

Mentally Ill Turn To Illegal Drugs To Feel Better, Expert Says

Many of the drug addicts living on Victoria's streets are people who
likely began medicating themselves to gain relief from undiagnosed or
unrecognized psychiatric issues -- and one day couldn't quit, says the
University of Victoria's new expert in illicit drugs and public health.

"We have an enormously large proportion of opioid or coke dependent
street drug users who have depression -- a range of 40 to 60 per
cent," said researcher Benedikt Fischer, adding that a large
proportion of them also have personality and anxiety disorders or
schizophrenia.

Fischer is the new director of the illicit drugs, public health and
policy unit at the university's Centre for Addictions Research B.C.
The former University of Toronto researcher arrived in Victoria in
July -- just a month before the issue of drug-addicted and homeless
mentally ill people became a hot topic.

That's when Dr. Anthony Barale, the clinical director of the Archie
Courtnall Centre for psychiatric emergencies, quit his job, arguing
that the new facility had become "a revolving door" for mentally ill
and drug addicted patients, and he didn't have the resources to deal
with them.

It's common for addiction and mental illness to go hand-in-hand,
Fischer said. When people with unrecognized, undiagnosed or untreated
psychiatric illnesses experiment with drugs, they find relief from
their mental health issues -- and quickly get hooked.

"It's a very, very sad story of the incompetence or very limited
competence of our medical system," Fischer said.

"That's how you create a cocaine addict," Fischer said. "You have
someone who is not more or less interested in coke than we are but has
a certain disposition of illness or care need that isn't otherwise
met. That's how people slip into self medication."

Soon the addiction completely masks a complicated and intensive
psychiatric illness.

"We see them primarily as addicts and we put them into addiction
treatments or send them to jail because that's what our drug laws say
- -- and no one looks after the latent psychiatric issue," Fischer said.

Although addiction care and psychiatric care belong closely together
they still operate very separately, Fischer said.

Addictions and psychiatry professionals should receive some
cross-training so as to properly intervene, treat or refer clients,
Fischer suggested. Ideally, their services would be located in one
centre, he added.

"It's not that one doctor can know everything -- but as long as they
recognize who the patient needs to see or where to send them, that's
where the system breaks down now, quite often."