Treatment of Drug Addictions and Mental Health

Seventeen years ago in 1996, I conducted research at the World Health Organization in Geneva, Switzerland. My assignment was titled “A World Atlas of Mental Health and Substance Use” – it was an ambitious evaluation of how the world’s regions fared in terms of policies and treatments for mental health and addictions. At that time, I was dismayed to see that Vancouver was ranked high in terms of the morbidity and mortality related to these problems but ranked low in terms of innovative policies and treatments for them.

Now, in 2013, the situation is completely different with much thanks going to Sam Sullivan’s unwavering vision, guts, and leadership in helping those in our city who are most in need. Tackling issues of homelessness, addictions, and mental health are never easy. With multiple stakeholders who often have conflicting agendas, many politicians steer clear from the highly charged problems that face an inner city population – but not Sam Sullivan. While other leaders were dodging bullets about Vancouver’s Down Town Eastside, Sam Sullivan wheeled right in and took up the fight.

As Vancouver City Councilor, Sam was a supporter of the establishment of North America’s only supervised injection site for people with drug addictions- the highly controversial Insite project. At the time, no one knew what the results would be but Sam collaborated with key scientists and policy makers and based his decision on solid research, not political sway – and thank goodness he did.

A 2008 cost-benefit analysis of the site in the Canadian Medical Association Journal observed net-savings of $18 million and an increase of 1175 life-years over ten years. A 2011 study in The Lancet found overdose deaths have dropped 35% in the Insite area since it opened, much more than 9% drop elsewhere in Vancouver. An editorial in the Canadian Medical Association Journal noted that after three years of research “a remarkable consensus that the facility reduces harm to users and the public developed among scientists, criminologists, and even the Vancouver Police Department.”

As Mayor, Sam raised the $175,000 required to develop the SALOME project proposal which has now received several million dollars of government and private funding commitments. The project will see hundreds of people with drug addictions in Vancouver transitioned from illegal street drugs to legal medications as a way of reducing crime, medical and other societal costs and improving health.

In 2010, Sam was awarded an Honorary Membership to the College of Family Physicians of Canada for his work on behalf of the needs of the homeless and inner-city populations and programs for those battling drug and substance abuse. At the time the award was made, the College said that “Mr. Sullivan has demonstrated courageous leadership in introducing and supporting programs for inner-city populations in need”. This recognition marks the first time a former Mayor received this award.

As a youth addiction psychiatrist, every day I see the devastating impact of untreated mental health and addictions. I see how depression, psychosis, withdrawal, suicide, violence, and crime crush individuals, their families, their communities, and their cities. The losses associated with these health problems are profound, last generations, and are a very real part of our beautiful city.

As a Vancouverite, I am proud of the progress our city has made in facing these issues head on and setting an example of innovation, progress, caring, and hope for the world to see and model. Sam Sullivan made that happen. Now in 2013, Sam’s renewed energy for the city he loves is building on the courage, wisdom, and compassion which he showed years ago – once again making Sam Sullivan, the leader our city needs.

Dr. Shimi Kang is a Clinical Associate Professor at the University of British Columbia; Medical Director, Child and Youth Mental Health, Vancouver Community – Vancouver Coastal Health; Founder, Provincial Youth Concurrent Disorders Program – BC Children’s Hospital; and a Psychiatrist with the Provincial Women’s Mental Health Program at BC Women’s Hospital.