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Addiction is not a choice. It is a chronic brain disease that requires treatment and management over time like other chronic illnesses.
Addiction is a pediatric illness. Ninety percent of the time it originates or is triggered by use before the age of 21. Addiction must be approached as an illness that affects our youth. Society has an obligation to protect youth from addiction (prevention) and protect youth with addiction (harm reduction and treatment). People with addiction often have other mental health conditions (called Concurrent Disorders). This complicates treatment and recovery.
Addiction is a chronic disease that must be managed over time.
Addiction is not an acute illness where you get treatment and you are cured. Like other chronic illnesses, people in recovery need ongoing health care and community supports to help them remain in recovery. We must build these supports. These include recovery high schools, sober dorms, housing, employment and a continuum of care.
Addiction affects the whole family.
One family member may struggle with addiction, but the whole family suffers. Family involvement and support is important during active addiction, treatment and recovery. Outcomes are best when people with addiction and their families learn coping skills and recover together. Families should be involved in the development of a treatment plan for our loved ones. People with addiction and their families should also be involved in the development of drug policies, health laws and the development of best practices, standards of care and guidelines for harm reduction and treatment.
Privacy laws need to be changed to acknowledge the role of family caregivers.
We must also develop best practices with respect to privacy laws as they relate to those with addiction and other mental health conditions. Family caregivers have an important role to play in supporting their loved ones.
Stigma (discrimination) must be acknowledged and eliminated.
Stigma results in the chronic underfunding of treatment for addiction and other mental health conditions and a poor quality of care for those affected and their families.
Reallocate resources from reducing supply to reducing demand.
Addiction, like other chronic illnesses, requires a public health approach, not a criminal justice approach. This means shifting the focus of our limited resources from enforcement to education, prevention, harm reduction and treatment. Those involved in low level crimes to fund their addiction should not be criminalized but treated and supported. Significantly more resources should be used to reduce the demand for drugs (through education, prevention, harm reduction and treatment) than are used to reduce the supply of drugs (the “war on drugs”).
Educate to change attitudes.
To date, education campaigns have focused on the dangers of drugs. That has not worked. We need to focus education so that we can have thoughtful conversations about:
- drug policy
- health laws
Prevention efforts occur at two levels.
The major risk factors for addiction include a genetic predisposition, male gender, early initiation of use, other mental health conditions, certain personality traits, and environmental factors such as adverse childhood experiences (trauma), neglect or abuse. Prevention efforts should include:
- screening, brief intervention and referral to treatment (SBIRT)
- addressing problematic personality traits (Preventure)
- treating other mental health conditions
- protection from abuse or neglect
- education regarding addiction, stigma, drug policy, and health laws.
A public health approach to substance use means adopting regulatory measures that apply to everyone in order to reduce the overall harm of substance use across the population. We believe these measures should include:
- a minimum age of purchase of 21
- a not-for-profit distribution model
- distribution by a government run monopoly which reports to the ministry of health (not the ministry of finance)
- no advertising or branding (which drive demand)
- minimum pricing adjusted annually to inflation
- increased taxes on increased concentrations of the substance.
Harm reduction services save lives and do not enable addiction.
Harm reduction services keep people alive so they can recover. Harm reduction is a means to an end. The end is recovery. There should be no age restriction to access safe injection sites. Because Canada does not have treatment on demand and does not allow for involuntary treatment, safe injection sites are the only way to protect our teenagers who are waiting for, or not seeking, treatment.
The greatest enabler of addiction is the lack of treatment.
It has been estimated that 80-90% of people with addiction do not receive treatment. We must eliminate barriers so that treatment is accessible, publicly-funded, timely, compassionate and evidence-based. Treatment meeting all these criteria is rarely available today. Those in detention or incarcerated who have addiction or other mental health conditions must receive the treatment they need.
Best practices must be developed to protect teenagers and adults with addiction who are waiting for treatment or not seeking treatment. It is not enough to say early intervention is key – we must actually intervene.
There are two types of people who use drugs.
- Non-problematic: The majority of people who take drugs (whether legal, illegal or prescribed) are not problematic users. They are not a threat to themselves or others. Giving them a criminal record is counter-productive, unjustifiable and a waste of public funds.
- Problematic: people struggling with addiction are ill and should not be criminalized for compulsive drug use. Criminalization harms recovery. Problematic drug use requires a public health response not a criminal justice response. They should receive evidence-based treatment and support.
For kids addicted to illegal drugs, government inaction allows them to play Russian roulette with their lives.
We would like to work with all levels of government on a plan to protect addicted youth; something more than short term help like Naloxone and detox.
- kids seeking treatment need treatment on demand – their next use could be fatal.
- kids not seeking treatment also need protection. They need either:
- a safe source of supply or
- where all other less intrusive interventions have failed, mandated treatment.
The federal government refuses to provide a safe source of supply and the provincial governments refuse to mandate treatment. So together, they allow addicted youth to play Russian roulette with their lives. It is not acceptable to wait until addicted youth hit “rock bottom” to provide treatment and support because too many will die before that.
We favour the strict regulation of cannabis.
Greater harm comes from prohibition than from strict regulation. People consume cannabis even though it is illegal. The best way to protect them is to regulate it.
- Compared with other drugs, marijuana is not as addicting. The addiction rate is 5-9% for adults and 17% for adolescents. This is less than tobacco (32%), heroin (23%), cocaine (17%) and alcohol (15%).
- Marijuana is not a “gateway drug”. Although there is a correlation between users of hard drugs and cannabis, there is no evidence of causation. The vast majority of cannabis users don’t go on to use hard drugs. To quote Dr. Carl Hart, “It would be like saying that the last three presidents of United States used marijuana before they became president. Therefore, marijuana is a gateway drug to the white-house.”
The possession of drugs for personal use should be decriminalized.
Prohibition is not preventing Canadians from using illegal drugs. According to the 2016 Canadian Community Health Survey, over 10% of Canadians aged 12 years or older reported using illicit substances in 2016. Young adults aged 18-34 were most likely (21.5%) to report drug use.
Decriminalization means possession of a drug for personal use is not subject to criminal sanctions, but it is still illegal to sell the drug. Based on the outcomes in Portugal concerns that decriminalization will increase drug use appear unfounded. Further, decriminalization reduces stigma which is one of the significant barriers to treatment. More people seeking treatment means that the harms of drug use, like HIV/AIDS and death, are substantially reduced.
Decriminalization is not enough. We need to control and regulate the market to reduce harms.
As the diagram below illustrates, harms are minimized when a substance is strictly regulated. Harms are maximized when the market is illegal (unregulated) or commercialized (under-regulated).
It is widely recognized that the war on drugs has been a costly failure. We regulate alcohol and tobacco, even though they can be harmful, because people will use them anyway. If we don’t control the market, then drug cartels will control the market.
Regulation is the best way to protect Canadians by:
- ensuring standard dosages
- ensuring products are not laced with toxic substances
- providing warnings on labels and packaging
- weakening drug cartels by competing with them and reducing their sources of income
- providing the governments with a new source of revenue that can be used to fund education, prevention, harm reduction and treatment
- minimizing the corruption caused by drug cartels especially in producing countries (Canadians are much less likely to experience the violence caused by our consumption)