Broad Exposure

A discussion with Mark Haden, a supervisor at Vancouver Coastal Health, a published author on drug policy in Canadian and international journals, an advocate of the failure of drug prohibition, a public educator on drugs and drug policy, and a member of the Keeping the Door Open (KDO) coalition. 

Mark is an advocate of drug policy reform with a number of publications on policy alternatives, and as such was very interested in being involved in our event. He provided a great deal of resources to assist in policy and in organizing and facilitating discussion at a dialogue such as the one we are proposing. As a member of the KDO coalition, Mark participates in open dialogue on drug policy and other drug related issues in Vancouver, much like the event we are hoping to launch for students.

To begin with, Mark described our dialogue event as ‘fascinating challenge’, whereas developing drug policy alternatives is no easy task. However, Mark welcomed the idea of ‘thinking outside the box’ and utilizing a collaboration of people for discussing policy alternatives especially those who may not commonly be exposed to an issue such as a addiction. In order to have the creative and innovative discussion necessary, we must have a variety of individuals speak about this issue and expose participants to a variety of views. The idea of collaboration is essential to the development of such novel alternatives. 

In exposing participants to such a variety of views however, it was recommended that we steer the discussion away from a debate format. As Mark suggested, the debate format often quickly narrows the discussion to only those views and people will tend to be less creative. Using more of an open dialogue approach to looking at addiction and drug policy will allow for a broader range of thought; people will be much more creative and apt to explore the edges of what is possible in approaching this topic. It was also suggested that the discussion not focus on the failures of current or previous policies, but strictly on the creative aspect of developing an alternative method. Perhaps our event discussion can focus specifically on foundations of a new model for drug policy and the best approach for an alternative.

A really great suggestion for recognizing the views of the whole group of participants was to use an activity that asks all the participants specific questions on how a specific drug should be controlled for a variety of drugs. This engaging exercise would create a collective model and help promote discussion in the smaller group exercise involving the development of policy alternatives.

Transforming Ideas

We have been given the opportunity to examine and develop a novel, sustainable solution to a social problem in Vancouver and we have chosen the issue of drug addiction. Through our research on substance abuse and drug policy, an overwhelming trend among professionals and supported by scientific research appears to be the ineffectiveness of drug prohibition in addressing drug issues and addiction. However, alternatives to prohibition for drug policy are complex and difficult to develop due to the differing public opinions that exist and the stigma associated with drug use. Drug policy alternatives for prohibition is the innovative issue we are interested in focusing on. 

Although this topic has been debated through public discourse and other means before, it has rarely been done involving university students whom normally would avoid such a topic. Exposing business students to such an issue we hope will be an innovative approach to developing discussion and policy suggestions. Our hope is to develop a day long event that encompasses professional speakers on drug use and addiction to inform, teams of students presented with a case study involving drug policy, and a presentation of the ideas to the professional panel for evaluation in a case competition format.  

The overall goals of this event are to educate university students on the topics of drug policy and addiction. These individuals are this city and nations future policy makers and current voters. The hope is to both transform the way that they look at drugs and addiction, combat the stigma that is often associated with drug use, and give them a chance to develop and propose novel policy alternatives for a more unconventional topic in a creative way. We also hope to not only inform and educate, but develop innovative policy alternatives with the guidance of those who are professionally involved in topic. 

Through the use of a seminar and case competition model, we hope to first facilitate an informed exploration of the issues surrounding substance use and drug policy. This will be done though presentations from drug professionals in our community and an open discussion format. 

In order to foster an attractive event, we are currently exploring a few options. Students and university faculties, especially business, thrive on competitive events. Providing a case competition regarding a social issue that so largely affects our own community may provide a driving force for participation. Partnering this event with an existing SFU socially oriented club may also be beneficial for attracting a varied student base.

The increasing popularity of social innovation and social issues may play a role in increasing the attractiveness for students to want to get involved in their community and for organizations to get involved in such an event as a sponsor. Another option we are exploring is to partner this type of event with SFU Business faculty  which would provide some form of credit or recognition to students for their participation, such as a social innovation certificate.

Over the next few weeks, we will be asking some critical questions exploring aspects of planning, coordinating, and funding an event such as this and evaluating its effectiveness in addressing the social issue of addiction through consultation with various professionals and policy makers. We invite comments, criticisms, and suggestions regarding our ideas as we envision novel solutions to such a prevalent social issue.

Staying Alive – Dr. Gabor Mate

Staying Alive – Dr. Gabor Mate | CBC News: the fifth estate

Gabor Mate has been the staff physician at Portland Hotel Society, a residence and harm reduction facility in the DTES, for the past ten years. He operates Onsite- a detox and addiction treatment center located with Insite, North America’s only legal, supervised safe injection site. He is also a best selling author of numerous publications on the social issue of addiction and advocating the transformation of drug policy.

The above video is a candid interview conducted with CBC’s Fifth Estate program in a segment called “Staying Alive”, showcasing Vancouver’s DTES neighborhood and raising awareness of the benefits of Insite. Mate begins by outlining what draws him to the troubled neighborhood stressing the large need that is present there. He sees a great deal of suffering and believes that the neighborhood is one where he can help the most and mitigate the suffering.

As seen in the video and his writings, he is an advocate of harm reduction drug policy. Mate describes it as not treating the disease or addiction directly, but reducing the harm caused by the habit to both the addict and the harms to society that arise due to the addiction. Although research regarding such approaches has showed positive benefits (see previous post), funding is not proportionally allocated to them. Mate argues this is a matter of ‘social priority’; money that is available goes predominantly to enforcement and other means that have shown to be largely ineffective. Harm reduction policies and programs may be better funded if public opinion and support were tilted toward it. 

Mate goes on to suggest this has been one of the success of Insite- public approval of the facility has gone up considerably since it opened among residents of Vancouver and business owners, and no political figure at the civic level opposes the facility. The altering of opinion towards Insite and harm reduction in Vancouver is a testament to the transformative power it has had among perception and in formulating drug policy as a result. He doesn’t describe Insite as a place for addicts to safely use drugs, but a place to ‘protect them from some of the worst effects of addiction”. This success is in addition to the improvements in the quality of life of addicts by reducing suffering through the use of such harm reduction programs. 

There is evidence and opinion to suggest that closing Insite, thereby increasing efforts toward enforcement and away from harm reduction, would result in negative consequences for addicts and the community. Mate claims of all studies completed regarding Insite’s benefits. they have all reported both health AND social benefits. Despite the ‘success’ claimed and benefits shown for harm reduction policies, such as the safe injection site, it remains as the only one in North America and funding continuing to be placed in what is called ‘ineffective’ policies. A solution to addiction and its negative residual effects on Vancouver community may require a radically different way of thinking among both policy makers at all levels and the general public.

Drug Distribution International (TSX: DDI)

The shift from traditional enforcement approaches to innovative approaches, or at least consideration of alternative approaches, seems to be gaining ground not only with U.S. administration but on a global scale.

Last week the United Nations released its annual World Drug Report which supported drug decriminalization as an approach to dealing with global drug issues- a reversal in opinion from previous years. It showed strong approval for public health rather than criminal enforcement strategies for for drug control and drug prohibition and control has only resulted in profits for gangs, cartels, and drug lords. It went further to say that controls on drugs have created a ‘black market’ of large proportions that utilizes violence and corruption.

The UN report has a heavy focus on Portugal, who in 2001 instituted a decriminalization of all drugs making them an administrative offense not a criminal offense. Although initial criticism of this decision was high, research emerging now shows that it had profound impact on drug issues. The report stated decriminalization has lead to a large reduction in drug overdose and HIV infection, has decreased drug use to the lowest in the European Union, and seen a 150 percent increase in the number of people entering addiction treatment along with a decrease in a number of other drug-related problems.

The fear over drug decriminalization appears to be that it would then become a legitimate economic enterprise. The opposing argument is that it already is economic with drug controls creating a lucrative black market for drug trafficking and distribution. The problem with this is that the large gains go into the hands of gangs and drug lords and it has been argued increase crime.

The current drug controls do little to address addiction directly, with little focus on treatment or assistance. Decriminalization may increase the amount of individuals entering treatment and decrease some of the adverse residual effects of drug abuse, as observed in Portugal. However, for this method to work there would need to be adequate measures in place to still control drugs and it would need to be in collaboration with a well structured addiction treatment program to be successful.

Celebrity Endorsement

The overwhelmingly traditional approach to drugs and drug use among policy makers and levels of government has been through enforcement means. This was especially evident over the last eight years with the Bush administration’s ‘War on Drugs’ which the current Obama administration has openly stated the approach has been a failure. This approach centers on curbing the illegal drug trade by decreasing supply and demand for such substances. It utilizes a set of laws and policies intended to discourage the production, distribution, and consumption of targeted substances.

The current administration’s Director of National Drug Policy, Gil Kerlikowske, stated in May that the War on Drugs would no longer be used to address drug issues as it is counter-productive and contrary to policy favoring treatment over incarceration for reducing drug use. A recent U.S. drug policy reversal in Afghanistan echoes these policy initiatives; the Obama administration has vowed to eliminate its poppy eradication program to combat the drug trade and focus on intercepting drugs and chemicals used to make them as well as going after drug lords.

President Obama and his National Drug administration also appears to making a similar shift in drug policy in the U.S itself- one that echoes the principles of drug policy here in Vancouver. Kerlikowske’s drug strategy shift from the war on drugs is Vancouver’s 4 pillars strategy exactly, according to an SFU criminologist, and recognizes that addiction is a disease and treating addicts as criminals has been largely ineffective at addressing drug issues. Kerlikowske stated himself:

“We have learned a great deal about the disease of drug addiction and know that treatment works. Through comprehensive and effective enforcement, education, prevention and treatment we will be successful in reducing illicit drug use and its devastating consequences.”

From a local perspective Vancouver currently makes use of both addiction treatment and alternative approaches to drugs and addiction, including Insite safe injection site and needle exchanges with its Four Pillar strategy. Dr. Evan Wood, editor of the Harm Reduction Journal and Director of the urban health program at BC Center for Excellence in HIV/AIDS, the body that conducts independent research on the effects and benefits of Insite in Vancouver, has spoken about the failure of prohibition and that drugs are not a simple law enforcement problem. Research has shown considerable benefits to Insite’s presence in the community, previously addressed in another post.

A successful, sustainable solution to drugs and addiction must approach the issue of addiction as a disease. This would stress treatment and health alternatives in place of enforcement and incarceration. Completely removing enforcement would likely provide adverse effects and there would likely be strong opposition. Dealing with the social issue of addiction requires an integrated approach- treating the addiction itself, combating the residual effects, controlling drug supply and demand, and enforcing those who are trafficking substances. Perhaps a better approach would be an integration of harm reduction, decriminalization, and control policies to have a single collaborative approach for addiction.