Saturday, January 18, 2014

Addiction Dialogues, West Vancouver

I was honored to be asked by David Berner to be apart of Addiction Dialogues.   A panel discussion would allow the community to discuss and answer the concerns of homeowners, citizens, parents, employers and others interested in what addiction is and what can be done about it at an individual, family, work and community level.
David Berner, Executive Director of the Drug Prevention Network of Canada, had founded the first residential treatment centre which began in Vancouver British Columbia as the X -Kalay foundation and continued in Manitoba with Jean Doucha and the Behavioural Health Foundation.   His recently published book, All the Way Home, tells of those early years. Today as well as being an endless crusader for truth and proponent of living life to its fullest, as a weekly talk show host  and addiction counsellor, he helped co found the first Recovery Day in Vancouver.
AnnMarie McCullough started the Faces and Voices of Recovery and began the first Recovery Day in Vancouver which now occurs nationwide.  She also leads work at Orchard Treatment Center.  She was radiant sitting beside me, her inherent beauty even more so, since her recent engagement announcement.
Lorinda Strang, Executive Director the the Orchard Treatment Centre sat next to me. Her experience and work in the field is especially well known to the community of West Vancouver where she raised her family.  Wealthy communities such as West Vancouver are preyed on by drug dealers, their children at greatest risk.  
Candace Plattor, Registered Clinical Counsellor, and author of Loving an Addict, Loving Yourself, completed our panel.
As moderator, David Berner opened by asking us all what we thought addiction was.
Candace spoke mostly to it’s impact on family and relationships as well as stealing the life from the individual.  In her work she as often cares for family members who find themselves pulled into the desperate chaos of those addicted to a variety of chemicals as well as the process addictions, like sex, internet, eating disorders, gambling.
Lorinda Strang spoke to the total destruction of the person’s life purpose and the loss of all their interests and relationships and their failures in their relationships and the workplace.  She described how positive it was that businesses and families were recognizing addiction earlier and getting these members to treatment centres such as Orchard earlier when successes were most assured. She described the denial process and the abhorrent thinking, the rationalizations that ‘explained away’ all manner of loss and failure but never addressed the addiction itself. She talked of the wasted lives she saw daily in their work, people arriving like zombies and becoming human again in their relationships with other, lives restored with hope and joy and purpose.  She spoke of detox as only a first phase but the next months made easier in a treatment centre but then the life long need for awareness. The disease of addiction is a waxing and waning  condition from which one may recover, as evidenced by the millions that have,  but still they carry the risk for relapse.
I spoke to the neurochemical evidence of disease, the  genetic evidence, the twin studies, fMRI data, the hijacked dissociative thinking likened to a computer virus or cancer so that a person begins to ‘worship’ and ‘serve ultimately as a slave’ their God of addiction despite ‘negative consequences’ such as health problems,  failure in school, athletics, loss of important relationships and inability to maintain or manage work at previous level.  Whereas I tended to quote studies and research and stats, boringly, impressed myself by the science, the others tended more to tell personal stories, speak of clients, their families, friends and lovers and the communities they knew.
AnnaMarie McCullough spoke to the negative effects on the individual and the community. She spoke to the stigma associated with the disease and the isolation the individual experiences and the road back to community which comes in the recovery.  She expressed concern about the ‘enabling’ individual and community services which were in as much denial as the individual with the disease of addiction. She spoke of Recovery Day’s function in increasing awareness and helping individuals and their communities see just how successful recovery is and how beneficial it was for the community.  She especially emphasized the joy that recovery restored and the love that people felt after often years of being desperately hiding and lying about their disease.
David Berner spoke to the grief and tragedy of the individuals who turned to addictions as their only solace and how this immediate relief then turned around and hurt them more and more as time went on.  He spoke to these individuals not wanting to be addicts, their mothers and fathers and brothers and sisters. He spoke to their being sick and the horrible lives they so often endured before  they became addicts. He spoke to the child who was physically and sexually abused and developed an addiction as a teen. More and more he said his concern was for the children who were turning to addictions and becoming horribly addicted because of the high risk teen agers have for addiction to marijuana, alcohol, cocaine, and all the process addiction. He said more and more the people he was seeing had not known any normal life having so often left homes and schools to follow their addictions.  He spoke eloquently for the tragedy of the addicted, their families, the loss to individuals and families. There is so much grief, he said.  He was sad that so many young addicts had lost the capacity to work and how much work had meant in his life, how addiction took away purpose from individuals he saw and yet how much joy he'd had himself having purpose in life and working to complete what he set out to do.
When the subject turned to treatment each individual spoke to the hope and the scientifically proven successes of a variety of treatments, the high success of 12 step programs and abstinence, the benefits of treatment centres and recovery houses, the amazing successes of the drug courts, the usefulness of urine testing and variety of medications and services that were of proven benefit.
Candace spoke of the benefits of the therapy to family members and how even when an addict didn’t respond family could learned to protect themselves from the consequences of the addictions and be prepared to help when they could.  She described her work of recovery with loved ones and how as they learned to take care of themselves the addicted one often came round.
Lorinda Strang talked  of the countless successes that she had seen in her 20 plus years working in Addictions and the work of the Orchard Treatment Center on Bowen Island. She described her anxieties raising her children in West Vancouver, the difficulties that wealthy communities faced when it came to addiction and what could be done for the community and the children.  Living in this community she had seen the success of recovery and still continued in contact with people who once were thought to be untreatable but had recovered and gone on to be shakers and makers of society.
I spoke of the need to treat addiction and mental illness, as a dual diagnosis.  Yes it was common for those who abused alcohol to be anxious and depressed (alcohol is a depressant - 2 drinks on occasion, beneficial, 3 or more drinks toxic)  No treatment of only the anxiety and depression was  going to improve the addiction. Freud said addicts and alcoholics were untreatable and Dr. Carl Jung said only a miracle would work.  Because addiction is a brain disease the thinking of the addict is diseased so one had to treat the addiction first then it was possible to address whatever mental illness was underlying. All the attempts at treating the ‘underlying’ conditions first were proven repeatedly to lead to failure in the majority of people, but especially children and teen agers.  It was like trying to stop the bleeding being made by slashing without taking the knife out of the persons hand.  Hence the dual diagnosis and concurrent treatment programs that focussed first on the addiction then as safety and stabilization was achieved more and more secondary treatment of the mental illness was incorporated into the overall treatment plan.
I said that the success of all addiction treatment was evident in the amazing society success of the anti smoking campaigns.  Being of an age when all such community meetings were in a 'cloud of tobacco' smoke one didn't even have to think of the actual incredible reduction in cigarette smoking in society.  The loss of adult sales had caused the evil tobacco empire to directly target children in their marketing campagns so to my mind, we'd stopped short not arresting the CEO”s of Tobacco Companies.
These were the people who were now looking to make even more money selling misery to the young  by offering their ‘marijuana smoke’ or maybe even a ‘lighter cigarette, one half tobacco and half marijuana’ . As Amsterdam and Holland have moved their BC Bud products into the most restricted drug category, the same as Heroin and Cocaine, these big business forces were pushing for legalization of marijuana so they could get greater access to the teen and children ‘customers’ .  All the abuse of drugs including heroin and cocaine, except marijuana, had been falling as a result of education and recovery but now big business was targeting the young with marijuana.
No smoke is ‘safe’ and all evidence points to the the extensive health costs of all smoke (tobacco, marijuana, cocaine) yet these same corporate individuals who profited from tobacco smoke are now funding the marketing behind the ‘legalization’ of another ‘smoke’.
(I think I got a little upset at this point and told of the three young men I’d seen last year who’d developed schizophrenia after smoking BC Bud, and spoke of my scotty dog being murdered by the drug dealers who objected to my refusal to lie about their positive urine tests when they wanted to get “safety sensitive’ jobs where the other workers there didn’t want cheech and chong ‘pot smokers’ in their midst because they caused so many workplace deaths and accidents’)
David Berner kept the topic on track and opened the floor to comments from the audience. One amazing young man spoke eloquently of his experience with addiction and recovery and seeing so many of his friend damaged by drugs and then those like himself who got clean and sober getting back to school like he did, getting work and having great lives compared to their previous lives.
The audience asked great questions.  Someone talked of Gabor Mate’s book, Hungry Ghosts and how it helped them understand the trauma of addiction. Asked about the use of hallucinogens to treat addiction, I pointed to the possibility of a ‘sexy’ treatment helping one individual in a thousand but that we’d seen such ‘sexy’ cancer cures come out of Mexico with false promise only to have people spend their life savings on these 1 in 1000 remedies and then die when they could have taken a safe and proven treatment.  
I commented on the local work and research of Dr. Ray Baker, who started the first Canadian addiction education program for medical students . Working in Occupational Medicine he speaks to the high success of addiction treatments, in the 80% range, when the disease is caught early enough that the person still has a job or is  in school and has supportive family.   Dr. Baker still shows that in those who are at the end stages of the disease, physical illness, unable to work, isolated, that the success that present day addiction treatments with modern approaches, 12 step programs, treatment centres and recovery centres is still greater than the rest of our medical colleagues treating end stage diseases like tuberculosis or diabetes.
There were excellent questions about the lack of government funding, specifically for adolesenct treatment facilities.  AnnMarie McCullough and Lorinda Strang spoke of the poor histories of past governments in their waking up to the epidemic of addiction but that increasingly the government has been on board with helping but still had to come to a better understanding. David Berner spoke of his meeting this week with the British Columbia Minister of Health, Terry Lake.  “Terry Lake was very concerned about addiction in the community, especially it’s affect on adolescents”.  The BC Liberals were invested in addressing the need for increased treatment.  An example was the support the new Turning Point Recovery House in West Vancouver had received from local and provincial government.
I answered the questions about changes in methadone ‘delivery’ policies stating that the primary concern of the College of Physicians and Surgeons of British Columbia was the safety of the citizens of BC.  The greatest concern of the College of Physician and Surgeons is the ‘diversion’ of methadone and the risk diverted methadone would pose for an adolescent or child.  The concern for that ‘risk’ was the basis of the review of the present day ‘delivery’ policies because some pharmacists had not been able to ensure the level of safety that the College of Physicians and Surgeons and their sister organization the College of Pharmacists require for the Methadone Program to run.
Regarding the question of Harm Reduction versus Abstinence I pointed out that the World Health Organization position was that all harm reduction program were only valid so far as they worked towards abstinence.  Controlled drinking had been a failure and as David Berner pointed out Mothers Against Drunk Drivers had done amazing work to ensure that judges, especially  remembered the danger that addicted persons posed to the community and didn’t just listen to the major alcohol  producer and sales lobby.
There was question too about some of the  more controversial local Harm Reduction programs. I quoted the Welsh study that showed that the lack of faith and hope of some counsellors for the recovery of their members was often far far less that the scientific evidence of success of the individuals themselves. In the Welsh study the ‘harm reduction’ counsellors had commonly given their ‘clients’ an under 10% or  30% likelihood of success when the follow up studies showed that 60% of these individuals a gained and maintained abstinence.  Dr. Marc Gallanter of Harvard showed that 80% of doctors maintained long term recovery in Alcolics Anonymous and Narcotics Anonymous many being 30, 40 and 50 years abstinent in his research.  I expressed the concern locally that no judge or doctor with addiction would be advised to accept a “harm reduction’ program whereas often that’s all my poor patients were being advised to take.  This white collar and blue collar approach to treatment was simply wrong.  Further when I talked to some of the harm reduction proponents they were really saying there was no 'hope' for their 'customers' and that they should be just given 'palliative care' (i.e. comfort, since no cure was available).  I found myself thinking of some of the people I'd met who had promoted 'euthanasia' for all mentally ill patients. I was so thankful that the Welsh study showed how wrong these individuals usually were.
Everyone loved Candace' concern for family and friends of addicts;  Lorinda’s experience and expertise helping individuals and family, the world renowned fine work of the Orchard Treatment Centre, AnnMarie McCullough’s passion for community and recovery and David Berners great sense of humour and skill as a public speaker and moderator.
I was just thankful to be apart of something very good  and be there for those special moments when David, AnnMarie, Lorinda and Candace’s words touched my very soul. The people who were present wanted the very best for their community as their presence, attention and questions showed.  I really admired them most

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