SPECIAL SERIES: THE FACES OF ADDICTION IN OUR COMMUNITY

One in 11 Hit by Substance Abuse

To most people, an alcoholic or drug addict is best represented by the
walking wounded on our downtown streets, the people we see drunk or
high, panhandling and sleeping in doorways.

But in reality, alcoholism and addiction re so widespread that it's
hard to find a erson or a family they haven't touched.

About 400,000 British Columbians are estimated to be suffering from
addiction or substance misuse, not including tobacco. With about 4.5
million people in B.C., that's about one in every 11 of us.

These aren't just people hanging out on Pandora Avenue. Most are our
co-workers, neighbours and friends. And these people don't get
treatment -either because they don't admit they have a problem, or
because getting help is too difficult.

So they end up in hospital or in court, and miss days at work -all
consequences with hefty price tags.

In a 2009 report, the B.C. Medical Association estimated the financial
burden of substance abuse in B.C. in 2006 was $6 billion a year -an
average of almost $1,500 for every man, woman and child.

The report, Stepping Forward: Improving Addiction Care in British Columbia,
recommended that addiction be recognized as a chronic, treatable disease.

The BCMA report said 40 per cent of that $6 billion went to direct
health costs and law enforcement. The biggest health cost was
hospitalization, estimated at $670 million.

One in every 10 visits to B.C. emergency departments is the result of
substance abuse. In 2004-05, it was estimated that 48,082 hospital
days -enough to fill Kelowna General Hospital every day for a year
- -dealt with substance abuse.

The other 60 per cent of that $6 billion was in indirect costs such as
disability, time away from work and insurance costs. According to
WorkSafe B.C., people who abuse alcohol or drugs are five times more
likely to file a workers' compensation claim and are three times more
likely to be absent or late for work.

Nils Jensen, who has been a Crown proseuctor for 15 years, says most
criminal court cases involve drugs or alcohol.

"It's very rare that you don't have alcohol or drugs as part of a
case. It really is."

The high price of drug and alcohol misuse is well understood -but
there is not enough money to pay for the solutions that are needed.

Addictions carry a lot of social stigma, and many people see them as
stemming from bad choices as opposed to bad luck.

As a result, society is often reluctant to fund programs. And before
any program can work, an addict needs to want to get help -and many
can't see past their addiction to do so.

Access is a huge problem. Unless an alcoholic or addict can pay about
$20,000 to go to a private treatment facility, it can be hard to get
the right help.

There are no public treatment centres on Vancouver Island. Instead,
there is a mix of services that require time and energy to navigate,
no easy task for someone fighting the effects of withdrawal.

Increasingly, governments are embracing harm reduction -the theory
that we should keep addicts alive and healthy until they seek help. It
has been criticized, how-ever, as a method that is reserved for the
poor and that enables them to keep using.

Harm reduction also tends to tackle the most visible substance abusers
- -the street-level addicts, who represent a fraction of the problem.

There is, however, one bright light. Last month, B.C. introduced
medical protocols for doctors to identify, assess and treat problem
drinkers. After the initial focus on alcohol abuse, the top addiction
problem in B.C., there will be protocols and guidelines for other
addictions. It's hoped family doctors can begin screening patients and
treating them for addictions as they would for other chronic diseases.

Dr. Eric Olson, a physician at the private Cedars treatment facility
in Cobble Hill, estimates that at least 25 to 30 per cent of visits to
a doctor are directly or indirectly linked to substance abuse, yet
traditionally doctors weren't trained in addictions.

"I graduated in 1977. I had a two-hour lecture on the effects of
alcohol and the liver. In my medical school training, that was it,"
Olson says.