Mayor Sam Sullivan is playing a leadership role in the formation of a group that is seeking a Health Canada exemption to allow ‘substitution treatment’ for people with chronic addictions. The exemption would allow doctors to prescribe legally available oral medications as substitutes for addictive illegal drugs.
Mayor Sullivan says the eventual goal of this form of treatment is to get people off drugs. “Prescribing legally available medications provides people an opportunity to regain stability in their lives and ultimately a path to abstinence,” he said. “Recognizing that drug addiction is one of the root causes of property crime and public disorder, I believe that this new approach will also help to reduce harm to the community.”
Mayor Sullivan noted that substitution treatment is a continuation of the Four Pillars concept pioneered by former Mayor Philip Owen, which advocates enforcement, education, treatment and harm reduction.
Introducing a prescription treatment program was one of a number of recommendations that came forward in the community consultations conducted by the Mayor as part of the development of Project Civil City. The new initiative aims to reduce homelessness as well as aggressive panhandling and the open drug market by at least 50 percent by 2010.
In addition to advocating for Federal government support for a new substitution treatment program, Mayor Sullivan has been in discussion with the Provincial government to encourage more funding for social housing and to provide supportive care for people with mental illnesses who are living on the street.
“One of the goals of this program is to separate the people with addictions and mental illnesses from the criminals,” said Mayor Sullivan. “Once this is achieved, our police will be in a better position to focus their resources on cracking down on criminals.”
The Mayor has been supportive of the efforts of independent consultant David Holtzman, former Executive Director of Leadership Vancouver and A Loving Spoonful, to form a non-profit society to develop and manage a substitution treatment research project. In consultation with the Mayor, Holtzman has engaged in informal discussions with a number of groups and individuals involved in the Downtown Eastside and drug addiction issues. Holtzman is developing a formal proposal that will be submitted to Health Canada by mid-February.
BACKGROUND: SUBSTITUTION TREATMENT FOR CHRONIC ADDICTION
THE SITUATION
Vancouver’s rates of illegal drug use, drug-related mortality, and drug-related pregnancy and childbirth complications, present problems that concern all Canadians. The most recent epidemiological data suggests over 33,000 British Columbians are dependent on illicit drugs. Property thefts, assaults, street prostitution, aggressive panhandling, dumpster diving, shoplifting and homelessness are, in many cases, directly related to people with chronic addictions desperately trying to find money to purchase illegal drugs. Addiction is the greatest threat to livability in Vancouver.
There is growing evidence that treating drug addiction from a health perspective dramatically decreases crime and public disorder. In addition, drug addiction treatment provides significant cost savings to private property owners and public systems such as enforcement, legal and health care. Every dollar invested in addiction treatment yields a $4-$7 reduction in drug-related crime. A study by the Canadian Centre in Substance Abuse found illegal drugs created direct and indirect costs of $8.2 billion. It is useful to note that prescription maintenance programs have been in place in the UK since the 1920s.
THE CONCEPT
Mayor Sullivan has been exploring the concept of substitution treatment since 2005. Initial discussions looked at substitution treatment as a possible vehicle to reduce the risks facing sex trade workers. The concept has since been expanded to include other addicted individuals and chronic offenders.
Mayor Sullivan is backing the formation of a non profit organization, to write and fund a research project that would work with addicted people to change their drug habits from illegal injection street drugs to legally available, orally-administered prescription medications. Health Canada must issue an exemption for the research trials to use prescription medications in this innovative way. The research would analyze the effects on both the user’s health and the community at large. Regular interaction with health professionals will facilitate interventions to help users develop an “exit strategy” to end their drug dependency.
Measurable outcomes for the project would include a reduction in the open drug market, a reduction in property crimes, and a reduction in aggressive panhandling and public nuisance complaints.
Traditional drug addiction treatments work for roughly one quarter of users — substitution treatment offers an option for the other three quarters. Ending drug dependency is the goal of substitution treatment. Substitution treatment is a means of reducing the users’ impact on public order and public health until durable solutions are reached.
Mayor Sullivan has held informal discussions with Federal and Provincial health officials, community leaders and user groups such as VANDU. Since beginning these discussions, he has been approached by a number of individuals who have offered to assist with funding.
David Holtzman is overseeing the formation of the project group. Holtzman has 25 years of experience as a Social Profit executive, with a BA in Economics (Simon Fraser University) and a MA in Leadership and Training (Royal Roads University). His management skills were integral to the on-going success of both A Loving Spoonful (Executive Director 1996-2001) and Leadership Vancouver (Executive Director 2001 — 2006).
The Four Pillars Drug Strategy, pioneered by former Mayor Philip Owen, is the City of Vancouver’s policy and plan for reducing drug-related harm in Vancouver. The four pillars are: prevention, treatment, harm reduction and enforcement.
The Four Pillars Coalition is made up of over 60 concerned local businesses and government and non-government organizations. It serves as a forum for ongoing dialogue and collaboration between the community, the Mayor and Council and City staff on the Four Pillars Drug Strategy.
Project Civil City is an initiative of Vancouver’s Mayor and Council aimed at eliminating homelessness, aggressive panhandling and the open drug market, with a minimum 50 per cent reduction by 2010. Project Civil City seeks to develop long-term and sustainable solutions to homelessness, drug addiction and mental illness.
