Mayor endorses controversial addiction program

Byline: Sean Condon
Source: The WestEnder
Feb 01 2007

Substituting certain drugs for others can help recovery, advocates say

Sharon Message was finally able to break her debilitating, years-long crack cocaine habit in the 1990s. Unfortunately, she did so by substituting it with crystal meth. While she was happy to have kicked the former, the 45-year-old mother was now addicted to the latter, a harmful psychostimulant drug.

However, the switch in substances did improve Message’s life. She was suddenly able to concentrate enough that, for the first time in years, she could sit down and read a book. She even went back to school. While she knew that crystal meth is a potential cause of psychosis, kidney damage and tooth decay, it was a trade-off she was willing to risk in order to try to put her life back on track.
In recognizing that the drug helped improve her focus, Message’s doctor was able to determine that she had Attention Deficit Hyperactivity Disorder (ADHD). In addition to some treatment programs, she was prescribed Ritalin, and she subsequently lost her craving for crystal meth.
Mayor Sam Sullivan hopes that Vancouver will launch a substitute-drug treatment program for the city’s cocaine and crystal-meth addicts that will lead to more success stories like Message’s. Last week, Sullivan announced that he would lobby the federal government for an exemption from Canada’s narcotics laws in order to implement the program for roughly 700 stimulant addicts. If approved, it would be the first of its kind, on this scale, in the world.
“In essence, I can see where [Sullivan] has an idea that [substitution treatment] may lessen the [addict’s] desire and move addiction from needles to pills,” says Message, who is now the executive secretary of the Vancouver Area Network of Drug Users (VANDU). She has been taking Ritalin for the past year. “I can’t speak for all addicts and users, but sometimes abstinence isn’t always the answer, and a maintenance program might be the only thing that works.”
Sullivan has been advocating a citywide drug-substitution program for the past two years, but this is the first time he has pushed forward a plan since he became mayor in 2005. In an interview with WE, Sullivan said this proposal is the next logical step in the city’s Four Pillars Drug Strategy. Heroin addicts can get methadone legally prescribed to them in order to cope with withdrawal, and Vancouver participates in the North American Opiate Medication Initiative (NAOMI) trails, which gives hardcore addicts free heroin, but there are no programs in place to deal with stimulant addicts.
“I personally believe that we need to look at drug addiction as a medical issue and even a disability issue, and not a moral or criminal issue,” says Sullivan.
There is little hard evidence of the impact substitute treatment has on stimulant addicts, but there have been a few successful programs in the U.S., England and Australia. Researchers in those countries found that cocaine addicts who were given dextroamphetamine, which is similar to Ritalin, reduced their cocaine use, spent more time in counselling, and had lower levels of depression and behavioural problems. Although some critics have expressed disapproval of taxpayers funding drug use, proponents of the plan point out that it has the potential to lower property crime.
“I don’t know how many times your car has been broken into [by drug addicts] in the West End, but mine certainly has lots,” says David Holtzman, a former director with A Loving Spoonful who is working with Sullivan in drafting up the program’s proposal. “If we came up with a plan where you’re saying [to addicts], ‘We have prescription medicine that will assist you in stabilizing your lives and will take away your need to commit different kinds of crime,’ wouldn’t that be a good thing?”
The biggest hurdle now standing in the way of the program receiving approval is the federal Conservative government, which was extremely reluctant to extend its legal exemption for Vancouver’s safe-injection site last year. Sullivan insists the Conservatives aren’t closed to the idea, pointing to the party’s recent about-face on climate change as proof that it’s open to change.
While there is still little detail about what Sullivan’s program will look like (he wants doctors and the higher levels of government to hammer out the specifics), the initial proposal has been well received by many in Vancouver’s medical community.
Maxine Davis, the executive director of the West End’s Dr. Peter Centre, says the program offers a “tremendous opportunity” for the city. She says 60 per cent of the centre’s clients are crack and crystal meth users, but adds that there are about 2,000 HIV-positive people in the Downtown Eastside who are eligible for therapy but go untreated. “It’s mostly due to their chaotic lives, because of drug use,” she says. “If that chaos can be taken out of their lives through substitution therapy, that would open them to possibilities of HIV treatment that has eluded them until now.”