Drug Prevention Network of Canada

Wonderful article in this morning’s New York Times

Opinionator – A Gathering of Opinion From Around the Web
June 10, 2012, 5:00 pm
The Fallacy of the ‘Hijacked Brain’
By PEG O’CONNOR

The Stone is a forum for contemporary philosophers on issues both timely and timeless.
Tags:

Addiction, determinism, free will, Philosophy

Of all the philosophical discussions that surface in contemporary life, the question of free will — mainly, the debate over whether or not we have it — is certainly one of the most persistent.

A popular analogy clouds our understanding of addiction.

That might seem odd, as the average person rarely seems to pause to reflect on whether their choices on, say, where they live, whom they marry, or what they eat for dinner, are their own or the inevitable outcome of a deterministic universe. Still, as James Atlas pointed out last month, the spate of “can’t help yourself” books would indicate that people are in fact deeply concerned with how much of their lives they can control. Perhaps that’s because, upon further reflection, we find that our understanding of free will lurks beneath many essential aspects of our existence.

One particularly interesting variation on this question appears in scientific, academic and therapeutic discussions about addiction. Many times, the question is framed as follows: “Is addiction a disease or a choice?”

The argument runs along these lines: If addiction is a disease, then in some ways it is out of our control and forecloses choices. A disease is a medical condition that develops outside of our control; it is, then, not a matter of choice. In the absence of choice, the addicted person is essentially relieved of responsibility. The addict has been overpowered by her addiction.

The counterargument describes addictive behavior as a choice. People whose use of drugs and alcohol leads to obvious problems but who continue to use them anyway are making choices to do so. Since those choices lead to addiction, blame and responsibility clearly rest on the addict’s shoulders. It then becomes more a matter of free will.

Recent scientific studies on the biochemical responses of the brain are currently tipping the scales toward the more deterministic view — of addiction as a disease. The structure of the brain’s reward system combined with certain biochemical responses and certain environments, they appear to show, cause people to become addicted.

In such studies, and in reports of them to news media, the term “the hijacked brain” often appears, along with other language that emphasizes the addict’s lack of choice in the matter. Sometimes the pleasure-reward system has been “commandeered.” Other times it “goes rogue.” These expressions are often accompanied by the conclusion that there are “addicted brains.”

The word “hijacked” is especially evocative; people often have a visceral reaction to it. I imagine that this is precisely why this term is becoming more commonly used in connection with addiction. But it is important to be aware of the effects of such language on our understanding.
Leif Parsons

When most people think of a hijacking, they picture a person, sometimes wearing a mask and always wielding some sort of weapon, who takes control of a car, plane or train. The hijacker may not himself drive or pilot the vehicle, but the violence involved leaves no doubt who is in charge. Someone can hijack a vehicle for a variety of reasons, but mostly it boils down to needing to escape or wanting to use the vehicle itself as a weapon in a greater plan. Hijacking is a means to an end; it is always and only oriented to the goals of the hijacker. Innocent victims are ripped from their normal lives by the violent intrusion of the hijacker.

In the “hijacked” view of addiction, the brain is the innocent victim of certain substances — alcohol, cocaine, nicotine or heroin, for example — as well as certain behaviors like eating, gambling or sexual activity. The drugs or the neurochemicals produced by the behaviors overpower and redirect the brain’s normal responses, and thus take control of (hijack) it. For addicted people, that martini or cigarette is the weapon-wielding hijacker who is going to compel certain behaviors.

To do this, drugs like alcohol and cocaine and behaviors like gambling light up the brain’s pleasure circuitry, often bringing a burst of euphoria. Other studies indicate that people who are addicted have lower dopamine and serotonin levels in their brains, which means that it takes more of a particular substance or behavior for them to experience pleasure or to reach a certain threshold of pleasure. People tend to want to maximize pleasure; we tend to do things that bring more of it. We also tend to chase it when it subsides, trying hard to recreate the same level of pleasure we have experienced in the past. It is not uncommon to hear addicts talking about wanting to experience the euphoria of a first high. Often they never reach it, but keep trying. All of this lends credence to the description of the brain as hijacked.
Related More From The Stone

Read previous contributions to this series.

Analogies and comparisons can be very effective and powerful tools in explanation, especially when the objects compared are not overtly and obviously similar at first glance. A comparison can be especially compelling when one of the objects is familiar or common and is wrested from its usual context. Similarities shared between disparate cases can help to highlight features in each that might otherwise escape notice. But analogies and comparisons always start to break down at some point, often when the differences are seen to be greater than similarities. This, I submit, is the case with understanding addiction as hijacking.

A hijacker comes from outside and takes control by violent means. A hijacker takes a vehicle that is not his; hijacking is always a form of stealing and kidnapping. A hijacker always takes someone else’s vehicle; you cannot hijack your own car. That is a type of nonsense or category mistake. Ludwig Wittgenstein offered that money passed from your left hand to your right is not a gift. The practical consequences of this action are not the same as those of a gift. Writing yourself a thank-you note would be absurd.

The analogy of addiction and hijacking involves the same category mistake as the money switched from hand to hand. You can treat yourself poorly, callously or violently. In such cases, we might say the person is engaging in acts of self-abuse and self-harm. Self-abuse can involve acting in ways that you know are not in your self-interest in some larger sense or that are contrary to your desires. This, however, is not hijacking; the practical consequences are quite different.

It might be tempting to claim that in an addiction scenario, the drugs or behaviors are the hijackers. However, those drugs and behaviors need to be done by the person herself (barring cases in which someone is given drugs and may be made chemically dependent). In the usual cases, an individual is the one putting chemicals into her body or engaging in certain behaviors in the hopes of getting high. This simply pushes the question back to whether a person can hijack herself.

There is a kind of intentionality to hijacking that clearly is absent in addiction. No one plans to become an addict. One certainly may plan to drink in reckless or dangerous ways, not with the intention of becoming an addict somewhere down the road. Addiction develops over time and requires repeated and worsening use.

In a hijacking situation, it is very easy to assign blame and responsibility. The villain is easy to identify. So are the victims, people who have had the bad luck to be in the wrong place at the wrong time. Hijacked people are given no choice in the matter.

A little logic is helpful here, since the “choice or disease” question rests on a false dilemma. This fallacy posits that only two options exist. Since there are only two options, they must be mutually exclusive. If we think, however, of addiction as involving both choice and disease, our outlook is likely to become more nuanced. For instance, the progression of many medical diseases is affected by the choices that individuals make. A patient who knows he has chronic obstructive pulmonary disease and refuses to wear a respirator or at least a mask while using noxious chemicals is making a choice that exacerbates his condition. A person who knows he meets the D.S.M.-IV criteria for chemical abuse, and that abuse is often the precursor to dependency, and still continues to use drugs, is making a choice, and thus bears responsibility for it.

Linking choice and responsibility is right in many ways, so long as we acknowledge that choice can be constrained in ways other than by force or overt coercion. There is no doubt that the choices of people progressing to addiction are constrained; compulsion and impulsiveness constrain choices. Many addicts will say that they choose to take that first drink or drug and that once they start they cannot stop. A classic binge drinker is a prime example; his choices are constrained with the first drink. He both has and does not have a choice. (That moment before the first drink or drug is what the philosopher Owen Flanagan describes as a “zone of control.”) But he still bears some degree of responsibility to others and to himself.

The complexity of each person’s experience with addiction should caution us to avoid false quandaries, like the one that requires us to define addiction as either disease or choice, and to adopt more nuanced conceptions. Addicts are neither hijackers nor victims. It is time to retire this analogy.

Peg O’Connor teaches philosophy at Gustavus Adolphus College in St. Peter, Minnesota. This year she is a recipient of an A.A. Heckman Fellowship scholarship for study at the Hazelden Pittman Alcohol Archives collection.

Please click on the “Statement from the Congress” below to get the full text of a declaration made in Stockholm, Sweden on May 23d by the WORLD FEDERATION AGAINST DRUGS.

It is a clear and courageous call for renewed efforts to further the goals of Prevention and Treatment world wide.

Statement from the Congress

Al Arsenault has sent us this piece in the Vancouver Courier by columnist Mark Hasiuk.

It shows clearly how the legalization mentality is not limited to drugs. We have been paying tax dollars in the DTES for social service agencies to run brothels.

These folks believe they are being compassionate and sensible.

They are neither.

I work with prostitutes every week. I don’t know one – I have never met one – who wants to be safe and secure in her or his renting out of body parts by the half hour.

Every prostitute I have ever met is sick and consumed with shame and wants to leave “the life.”

The following is the summary of an Angus Reid poll done for he Salvation Army and forwarded to us by Mario Conseco of Angus Reid.

The complete 12 page report is available here.

Canada Speaks 2012: New Report Reveals Canadians Empathetic Towards Those Suffering From Mental Illness & Addiction

Results from national opinion poll indicate public wants to see more done for those affected

TORONTO, May 1, 2012 /CNW/ – For the second consecutive year, The Salvation Army is announcing May as Dignity Month, and is releasing a report, “Canada Speaks 2012: Mental Health, Addictions and the Roots of Poverty.” The report reveals perceptions and attitudes among the Canadian public about individuals dealing with addiction or suffering from mental illness.

The survey of more than 1,000 Canadians, conducted in February by Angus Reid Public Opinion, revealed that many Canadians have been personally touched by the issue, with 80 percent reporting that they have either a friend or family member who has experienced mental illness and/or addiction. Due to this surprising number, many Canadians empathize with those that suffer from either mental illness and/or addiction and are looking to the government and social service programs to provide additional assistance to these individuals and their families.

Key findings from our report include:

Most Canadians recognize the linkage between mental health and addiction with 71 percent agreeing that “a lot of people with addictions have mental health problems.”
80 percent of survey respondents reported their belief that mental illness causes many Canadians to experience poverty.
87 percent of respondents believe that mental illness should be a higher priority for the government.
84 percent of those surveyed think that there should be more services to help people with addictions.

“In previous reports that we have released, we have seen a Canadian public that hasn’t always been sensitive to, or didn’t understand the needs of vulnerable people in our society,” said Commissioner Brian Peddle, Territorial Commander for The Salvation Army in Canada and Bermuda. “Our latest report revealed an entirely different population, one that is extremely empathetic to those struggling with mental illness and addiction and hope for a better and brighter future for them.”

The Salvation Army is highlighting the issue of mental illness and addiction this month as part of its annual May Campaign and the ongoing Dignity Project. Funds raised during the campaign will directly support those living in poverty today through social services like emergency shelter care, substance abuse counselling and employment training.

The Dignity Project is designed to inspire and educate the public about what it means to live in poverty – and what they can do to help. Through social networking and other communications outreach, The Salvation Army will engage Canadians about the reality of poverty in the 21st century.

“The findings from this year’s report are promising and reveal a population that recognizes the barriers and obstacles facing Canadians that suffer from either mental illness or addiction and how it can lead to a life of poverty,” said Commissioner Peddle. “Many people who seek the assistance of The Salvation Army are affected by one of these issues, so we are pleased that the public is eager to do more to help. The Salvation Army is working today and everyday to restore hope and dignity to all who need our help, regardless of their circumstance.”

The Salvation Army provides direct, compassionate, hands-on service to more than 1.7 million people in Canada each year, restoring hope and dignity to the most vulnerable in society. As an international Christian organization that welcomes everyone, The Salvation Army’s faith motivates its mission to serve and to treat everyone with dignity and respect.

The following article from the National Post was sent to us by Darcy Ulmer of our member organization Baldy Hughes Therapeutic Community.

George F. Will: Legalized drugs would solve one problem, create many more

George F. Will Apr 5, 2012 – 8:59 AM ET | Last Updated: Apr 5, 2012 8:55 AM ET

WASHINGTON — The human nervous system interacts in pleasing and addictive ways with certain molecules derived from some plants, which is why humans may have developed beer before they developed bread. Psychoactive — consciousness-altering — and addictive drugs are natural, a fact that should immunize policymakers against extravagant hopes as they cope with America’s drug problem, which is convulsing some nations to our south.

The costs — human, financial and social — of combating (most) drugs are prompting calls for decriminalization or legalization. America should, however, learn from the psychoactive drug used by a majority of American adults — alcohol.

Mark Kleiman of UCLA, a policy analyst, was recently discussing drug policy with someone who said he had no experience with illegal drugs, not even marijuana, because he is of “the gin generation.” Ah, said Kleiman, gin: “A much more dangerous drug.” Twenty percent of all American prisoners — 500,000 people — are incarcerated for dealing illegal drugs, but alcohol causes as much as half of America’s criminal violence and vehicular fatalities.

Drinking alcohol had been a widely exercised private right for millennia when America tried to prohibit it. As a public health measure, Prohibition “worked”: Alcohol-related illnesses declined dramatically. As the monetary cost of drinking tripled, deaths from cirrhosis of the liver declined by a third. This improvement was, however, paid for in the coin of rampant criminality and disrespect for law.

Prohibition resembled what is today called decriminalization: It did not make drinking illegal; it criminalized the making, importing, transporting or selling of alcohol. Drinking remained legal, so oceans of it were made, imported, transported and sold.

Another legal drug, nicotine, kills more people than do alcohol and all illegal drugs — combined. For decades, government has aggressively publicized the health risks of smoking and made it unfashionable, stigmatized, expensive and inconvenient. Yet 20 percent of every rising American generation becomes addicted to nicotine.

So, suppose cocaine or heroin were legalized and marketed as cigarettes and alcohol are. And suppose the level of addiction were to replicate the 7 percent of adults suffering from alcohol abuse or dependency. That would be a public health disaster. As the late James Q. Wilson said, nicotine shortens life, cocaine debases it.

Still, because the costs of prohibition – interdiction, mass incarceration, etc. — are staggeringly high, some people say, “Let’s just try legalization for a while.” Society is not, however, like a controlled laboratory; in society, experiments that produce disappointing or unexpected results cannot be tidily reversed.

Legalized marijuana could be produced for much less than a tenth of its current price as an illegal commodity. Legalization of cocaine and heroin would cut their prices, too; they would sell for a tiny percentage of their current prices. And using high excise taxes to maintain cocaine and heroin prices at current levels would produce widespread tax evasion — and an illegal market.

Furthermore, legalization would mean drugs of reliable quality would be conveniently available from clean stores for customers not risking the stigma of breaking the law in furtive transactions with unsavory people. So there is no reason to think today’s levels of addiction are anywhere near the levels that would be reached under legalization.

Regarding the interdicting of drug shipments, capturing “kingpin” distributors and incarcerating dealers, consider data from the book “Drugs and Drug Policy: What Everyone Needs to Know” by Kleiman, Jonathan Caulkins and Angela Hawken. Almost all heroin comes from poppies grown on 4 percent of the arable land of one country — Afghanistan. Four South American countries – Colombia, Ecuador, Peru and Bolivia — produce more than 90 percent of the world’s cocaine. But attempts to decrease production in source countries produce the “balloon effect.” Squeeze a balloon in one spot, it bulges in another. Suppress production of poppies or coca leaves here, production moves there. The $8 billion Plan Colombia was a melancholy success, reducing coca production there 65 percent, while production increased 40 percent in Peru and doubled in Bolivia.

In the 1980s, when “cocaine cowboys” made Miami lawless, the U.S. government created the South Florida Task Force to interdict cocaine shipped from Central and South America by small planes and cigarette boats. This interdiction was so successful the cartels opened new delivery routes. Tranquility in Miami was purchased at the price of mayhem in Mexico.

America spends 20 times more on drug control than all the world’s poppy and coca growers earn. A subsequent column will suggest a more economic approach to the “natural” problem of drugs.

George Will’s email address is ge********@******st.com.

Legalized Drugs: Dumber Than You May Think

May 7, 2012, Vol. 17

Author | John P. Walters

Even smart people make mistakes?—?sometimes surprisingly large ones. A current example is drug legalization, which way too many smart people consider a good idea. They offer three bad arguments.

First, they contend, “the drug war has failed”?—?despite years of effort we have been unable to reduce the drug problem. Actually, as imperfect as surveys may be, they present overwhelming evidence that the drug problem is growing smaller and has fallen in response to known, effective measures. Americans use illegal drugs at substantially lower rates than when systematic measurement began in 1979?—?down almost 40 percent. Marijuana use is down by almost half since its peak in the late 1970s, and cocaine use is down by 80 percent since its peak in the mid-1980s. Serious challenges with crack, meth, and prescription drug abuse have not changed the broad overall trend: Drug use has declined for the last 40 years, as has drug crime.

The decades of decline coincide with tougher laws, popular disapproval of drug use, and powerful demand reduction measures such as drug treatment in the criminal justice system and drug testing. The drop also tracks successful attacks on supply?—?as in the reduction of cocaine production in Colombia and the successful attack on meth production in the United States. Compared with most areas of public policy, drug control measures are quite effective when properly designed and sustained.

Drug enforcement keeps the price of illegal drugs at hundreds of times the simple cost of producing them. To destroy the criminal market, legalization would have to include a massive price cut, dramatically stimulating use and addiction. Legalization advocates typically ignore the science. Risk varies a bit, but all of us and a variety of other living things?—?monkeys, rats, and mice?—?can become addicted if exposed to addictive substances in sufficient concentrations, frequently enough, and over a sufficient amount of time. It is beyond question that more people using drugs, more frequently, will result in more addiction.

About a third of illegal drug users are thought to be addicted (or close enough to it to need treatment), and the actual number is probably higher. There are now at least 21 million drug users, and at least 7 million need treatment. How much could that rise? Well, there are now almost 60 million cigarette smokers and over 130 million who use alcohol each month. It is irrational to believe that legalization would not increase addiction by millions.

We can learn from experience. Legalization has been tried in various forms, and every nation that has tried it has reversed course sooner or later. America’s first cocaine epidemic occurred in the late 19th century, when there were no laws restricting the sale or use of the drug. That epidemic led to some of the first drug laws, and the epidemic subsided. Over a decade ago the Netherlands was the model for legalization. However, the Dutch have reversed course, as have Sweden and Britain (twice). The newest example for legalization advocates is Portugal, but as time passes the evidence there grows of rising crime, blood-borne disease, and drug usage.

The lessons of history are the lessons of the street. Sections of our cities have tolerated or accepted the sale and use of drugs. We can see for ourselves that life is not the same or better in these places, it is much worse. If they can, people move away and stay away. Every instance of legalization confirms that once you increase the number of drug users and the addicted, it is difficult to undo your mistake.

The most recent form of legalization?—?pretending smoked marijuana is medicine?—?is following precisely the pattern of past failure. The majority of the states and localities that have tried it are moving to correct their mistake, from California to Michigan. Unfortunately, Washington, D.C., is about to start down this path?s. It will end badly.

The second false argument for legalization is that drug laws have filled our prisons with low-level, non-violent offenders. The prison population has increased substantially over the past 30 years, but the population on probation is much larger and has grown almost as fast. The portion of the prison population associated with drug offenses has been declining, not growing. The number of diversion programs for substance abusers who commit crimes has grown to such an extent that the criminal justice system is now the single largest reason Americans enter drug treatment.

Despite constant misrepresentation of who is in prison and why, the criminal justice system has steadily and effectively focused on violent and repeat offenders. The unfortunate fact is that there are too many people in prison because there are too many criminals. With the rare exceptions that can be expected from human institutions, the criminal justice system is not convicting the innocent.

Most recently, crime and violence in Central America and Mexico have become the third bad reason to legalize drugs. Even some foreign leaders have joined in claiming that violent groups in Latin America would be substantially weakened or eliminated if drugs were legal.

Many factors have driven this misguided argument. First, while President Álvaro Uribe in Colombia and President Felipe Calderón in Mexico demonstrated brave and consequential leadership against crime and terror, such leadership is rare. For both the less competent and the corrupt, the classic response in politics is to blame someone else for your failure.

The real challenge is to establish the rule of law in places that have weak, corrupt, or utterly inadequate institutions of justice. Yes, the cartels and violent gangs gain money from the drug trade, but they engage in the full range of criminal activities?—?murder for hire, human trafficking, bank robbery, protection rackets, car theft, and kidnapping, among others. They seek to control areas and rule with organized criminal force. This is not a new phenomenon, and legalizing drugs will not stop it. In fact, U.S. drug laws are a powerful means of working with foreign partners to attack violent groups and bring their leaders to justice.

Legalization advocates usually claim that alcohol prohibition caused organized crime in the United States and its repeal ended the threat. This is widely believed and utterly false. Criminal organizations existed before and after prohibition. Violent criminal organizations exist until they are destroyed by institutions of justice, by each other, or by authoritarian measures fueled by popular fear. No honest criminal justice official or family in this hemisphere will be safer tomorrow if drugs are legalized?—?and the serious among them know it.

Are the calls for legalization merely superficial?—?silly background noise in the context of more fundamental problems? Does this talk make any difference? Well, suppose someone you know said, “Crack and heroin and meth are great, and I am going to give them to my brothers and sisters, my children and my grandchildren.” If you find that statement absurd, irresponsible, or obscene, then at some level you appreciate that drugs cannot be accepted in civilized society. Those who talk of legalization do not speak about giving drugs to their families, of course; they seem to expect drugs to victimize someone else’s family.

Irresponsible talk of legalization weakens public resolve against use and addiction. It attacks the moral clarity that supports responsible behavior and the strength of key institutions. Talk of legalization today has a real cost to our families and families in other places. The best remedy would be some thoughtful reflection on the drug problem and what we say about it.

http://www.weeklystandard.com/author/john-p.-walters

War on drugs failed?

War on Drugs! We haven’t had a war on drugs since the introduction of Harm Minimisation policies and the subsequent ‘hijacking’ of that policy platform by the one dimensional drug use promoting Harm Reduction strategy.

Let’s do a quick juxtapose; Poverty, child exploitation, crime, assault, murder, rape – these things continue to be a plague in our even ‘advanced’ western cultures and often don’t diminish and even increase at times, but at no point do functional, sane people declare attempts to combat or curb these social blights futile, and that one clear experimental option we haven’t tried and need to, is decriminalising such behaviour!

The ‘decriminalisation experiment’ is not for the benefit of the current and emerging generations mental, physical and social health or even community well-being, rather it is to assuage the cries of drug addled hedonists or nihilistic self-destructive pursuits of a few libertine social experimenters. In this cacophony of pseudo-intellectual ‘rationalism’ we are tacitly urged to abandon a generation to a social experiment which only legacy will be community, familial and individual loss and tragedy.

Shane Varcoe – Executive Director

Dalgarno Institute, Australia

In two recent editorials, the Globe called the war on drugs a dreadful failure and Insite an inspiring success. Legalization is the current theme.

DPNC Vice-President Gwen Landolt sent them this reply:

In its ongoing campaign to decriminalize marijuana, The Globe and Mail relies on the bizarre argument that decriminalization will reduce the drug cartel’s power and wealth (editorial -April 27, 2012).

This ignores the fact that this cannot ease the level of crime and violence, because it will not stop the profit motivation of drug traffickers. Without legal prohibitions, the traffickers will only increase their trafficking of the drug to many more users since there would be no legal restrictions against its use. The huge profits resulting from such sales will encourage even more money laundering, and criminals inextricably linked with other international organized crime. This is already happening with gangsters from British Columbia increasingly doing business with drug cartels in Mexico: this association will only increase if marijuana is decriminalized.

The resources of law enforcement, can in no way, stop this illegal activity unless demand is curbed by prohibition.

Antonio Mario Costa, Executive Director of the UN Office on Drugs and Crime (UNODC), stated, in his 2007 report, that legal controls on drug use have been highly successful. Over the last decade, world output of cocaine and amphetamines has been stabilized, with reduction in marijuana use and opium production. Without legal prohibitions against these drugs, there would have been even more drug chaos.

C. Gwendolyn Landolt

National V.P.

Item number nine in the letter to members of the Cat Lake reserve from the children in Grade Six is as blunt as it is painful.

“It hurts us and shoomis and kokum (grandpa and grandma) when you’re doing drugs and you’re not at home.”

Cat Lake is the epicentre of prescription drug addiction in Canada. Community leaders figure that between 70 and 80 per cent of the adults are hooked on narcotic pain killers OxyContin or Percocets.

Governments and local health authorities are slowly gearing up to deal with the runaway addiction that has slammed communities across the country, but especially First Nations.

But the help can’t come quickly enough for the children of Cat Lake.

“We feel that we don’t know what to do to help you stop doing Drug,” the children wrote as “Point Number Five.”

“We want you to stop because it hurts our family and we don’t like it when we’re angry,” according to point number four.

The children in this lake-soaked corner of northwestern Ontario 400 kilometres north of Thunder Bay put together the list over the course of a few days in a workshop with the help of a local band member.

They are desperately yearning for ways to end to the crisis in their community that triggered waves of theft and left children hungry and bereft of the stability and support they crave.

Out of a population of about 700, local officials say they collect 500 needles a week through the needle-exchange program.

They have put 172 adults on their list of confirmed addicts, and another 250 are suspected. Almost everyone else is either a child or an elder.

Oxy, the highly addictive and extremely expensive little pill, has become a way of life here and in many reserves.

The drug is supposed to be taken for intense pain, by prescription only. It produces an instant high when crushed, snorted or injected and that high has triggered a massive demand for the drug across the continent. Some of the biggest profits are drawn from some of the poorest people in Canada.

In Cat Lake and other parts of northwestern Ontario, health care workers just assume most of their adult patients are using.

And yet, the narcotic pain killer is no longer being produced.

Purdue Pharmaceuticals has pulled it from the shelves, prompting First Nations leaders to warn of a pending crisis of withdrawal for which no one is well prepared.

Oxy addicts can build up a tolerance and require larger, more frequent doses to get high. But kicking the addiction, for many, is too punishing many to bear.

Abnormal sleeping patterns, violent shakes, diarrhea, headache and anxiety are common, for days on end. Relapses are frequent.

The dealers’ stockpiles of the opioid are now dwindling and the price is climbing steeply. Authorities have been bracing for a withdrawal epidemic on reserves.

Const. Kyle Brend of the Nishnawbe-Aski Police force in Cat Lake said the spike in price for the drug has forced users to reconsider their habits — but not always for the better.

A full-strength pill can sell for about $1000 and a quarter-dose for about $250. When a supply would come into the community, users would scour their houses for possessions to sell, hit up their relatives for cash, raid their savings, or gamble for cash, Brend said. There’s a bit less of the door-to-door scavenging for drug money of late.

“You sell a digital camera for $60. You sell a couple things like that, you have money. It’s getting harder nowadays with the prices.”

Instead, addicts are looking for other ways to get high.

Rumours and Internet chatter about how to abuse the new version of Oxycontin — called OxyNEO — abound. Health workers suspect increased usage of cocaine and especially morphine. Brend sees evidence of more booze, even though Cat Lake, like many reserves in the area, is supposed to be dry.

“Now it seems there’s a lot of drinking to offset what they’re not getting in the pills.”

The police are cracking down as best they can on contraband. But even though Cat Lake has only one entry point — the airport — now that the winter road has melted, the community has only ever ejectedone person for dealing, Brend recalls.

The pills are easy to hide — in pockets, packages, even inside diapers or the lining of clothing. The entire community knows who is dealing, including the chief and council as well as the police, but authorities never catch them in the act because they are protected by tight-knit family and friends.
Half of adults in North Caribou Lake struggle with addiction

In North Caribou Lake, another northwestern Ontario community struggling with addictions, a 20-something dealer stands out in the street in broad daylight, surrounded by a small group of band members. He melts away when anyone in authority casts a wary eye.

So instead of focusing on crime and punishment, community leaders focus on healing the addicted and convincing any remaining non-users to stay clean.

“STOP NOW!” reads item number 8 on the children’s list. “We want you to get help and get better.”

Help on that front is on the way, but ever so slowly, and in small doses. Stopping right now is far easier said than done.

In North Caribou Lake, where about half the adults are addicted, the local nursing station is not yet set up with the medical treatment program that many health authorities believe is the most effective way to kick oxy addictions. The medical treatment, Suboxone, mitigates the horrible withdrawal symptoms. But the recovery program takes weeks and requires health authorities to monitor the patients very closely.

Many reserves in the region can only administer Suboxone in rare cases, under specific circumstances. The nurses in charge of the day-to-day health of remote communities aren’t empowered to set up full-fledged treatment programs. That’s changing, but ever so gradually.

In Sioux Lookout — a short flight to the south of Cat Lake and North Caribou Lake — the hospital just added a five-bed unit for mental health. The unit has quickly turned into an oxy treatment centre. But with thousands of addicts in the region, the beds are always full and the wait list is growing longer, now standing at four months.

In Cat Lake, Health Canada and band administrators are scrambling to start a Suboxone program that will combine a land-based recovery.

They had trouble finding space for a recovery centre, since housing and infrastructure are in severe short supply. They plan to convert an old building near the band office into a respite where Suboxone can be administered and patients can be monitored closely for a week.

Then, the recovering addicts will be sent out into the bush, with few supplies except the very basics. For several weeks, under the eye of a health professional, they’ll set up camp, hunt, fish, soak in nature, and — hopefully — conquer their addictions.

The first intake of three people starts on April 30. The waiting list has 15 names on it. But it should have hundreds, says health director Valerie Spence.

Still, it’s something.

“It’s a relief actually. I can breathe,” says Spence. “It was really hard seeing my family, my friends, all getting sick. I have a niece, she went to withdraw for about two weeks. I saw first-hand how it can effect people. She used to be normal. She’s not the same any more…..She lost herself, I would say. She’s slowly coming back.”

But down in Sioux Lookout, the co-medical director of the First Nations Health Authority is not breathing any sigh of relief. Dr. Claudette Chase despairs over the lack of comprehensive plan that would, she believes, treat more people and prevent so many relapses.

Recovering addicts need a “seamless service”, not just in regional centres, but in their own communities so that the help they receive stands a chance of sticking.

“We’ve got the Cadillac service for three weeks, and (then) often people drop off the face of the earth, to nothing.”

Some recovering addicts from Cat Lake seek out family and friend support in other communities so that they don’t have to go back to the oxy-dominated society of their home reserve. But Chase has come to expect relapse.

“Most patients who have left the unit, not all, but most of them who didn’t go on maintenance have eventually relapsed. Because often they go home, and the communities are trying very hard to build support services but it’s early stages,” she said.

Canadians need to ask themselves, however, why they and their governments are so willing to fund and support heart surgery or hospitalization for drug addicts in their final days, but won’t embrace what’s needed to control the crisis, she added.

“I do think that’s an important question for us to ask ourselves. Why is this happening? Why won’t we take this on? Because it is so far from rocket science,” she said.

“It would be great to see Health Canada jump in with both feet.”

That way, Chase said, the parents would stand a chance of making good on Item Number 11 of the children’s list: “Please go for treatment and get HEALTHY!”

February 15, 2012

Presented to:

Standing Senate Committee on Legal and Constitutional Affairs

By:

DRUG PREVENTION NETWORK OF CANADA
4438 West 10th Avenue, Suite 178
Vancouver, BC V6R 4R8
(604) 731-2425

Standing Senate Committee on Legal and Constitutional Affairs

Re: Bill C-10
Amendments to Controlled Drugs and Substances Act (CDSA)
Part 2, Clauses 32-33, 39-48, and 50-51

Illicit drug use imposes tremendous economic and social costs on society in the form of health care, enforcement, loss of productivity in the workplace and at home, disability and death of addicts.

According to Antonio Mario Costa, Executive Director of the UN Office on Drugs and Crime (UNODC), however, legal controls on drug use have been highly successful.[i] This is contrary to some claims, based solely on ideology, that prohibition does not work. The latter is an incorrect assumption.

One has only to analyze the results of prohibition in the US between 1920 and 1933. Alcohol consumption declined dramatically during prohibition, noted by the large decrease in cirrhosis deaths (29.5 per 100,000 in 1911 and 10.7 in 1929). Admissions to State mental hospitals for alcoholic psychosis declined from 10.1 per 100,000 in 1919 to 4.7 in 1928. Arrests for public drunkenness and disorderly conduct declined by 50%.[ii]

For the population as a whole, the best estimates are that consumption of alcohol declined by 30% to 50%. That is, prohibition did not end alcohol use, but it did succeed by reducing by one-third the consumption of a product that had wide historical and popular sanction.[iii] In contrast, the use of marijuana, heroin and other controlled drugs have never been a widely accepted activity in the US or in Canada.

Parliament’s Role to Determine Appropriate Sentences

It is Parliament’s role to advise courts and judges across the country, so that offenders are led to understand the severity of the offences they commit. This objective can be achieved, inter alia, by mandatory minimum sentences. Unfortunately, the application of judicial discretion in sentencing does not always achieve this objective. It is detrimental to the interests of the Canadian public to rely solely on judicial discretion in sentencing, as it can lead to a loss of confidence and faith in the criminal justice system. This is due to the fact that, regretfully, judicial discretion does not necessarily mean the application of common sense by judges when sentencing. In fact, judges, when sentencing, have frequently failed to balance the objectives of denunciation and general deterrence, with their desire for rehabilitation of the offender. This has led, in all too many instances, to a chaotic sentencing regime for offences, especially in regard to marijuana grow ops and marijuana possession. That is, operators of grow-ops all too frequently are given minimum fines, and this “slap on the wrist” approach is regarded by the offenders as merely the cost of doing business, and in no way serves as a deterrent. According to The Royal Canadian Mounted Police Report (2009) on the illicit drug situation in Canada, domestically produced marijuana continues to provide a source of considerable profit for Canadian based organized crime.[iv]

Similarly, possession of cannabis is regarded by some liberal judges, for personal ideological reasons, to be merely a minor offence. Consequently, in exercising their “discretion”, they have mostly handed down sentences of probation only.[v]

According to the UN Office of Drugs and Crime (July 2007), Canada has the highest proportion of marijuana users in the industrialized world, reaching 16.8% of those between 15 and 64 years of age. Cannabis offences rose 13% in Canada between 2009-2010.[vi] The lenient sentencing (probation only) for cannabis possession has led to a public perception that marijuana use does not cause harm. Well-informed individuals should understand, however, that marijuana is not a harmless drug. In fact, there are many, many studies indicating the contrary. Please refer to our website https://dpnoc.org/, under the heading, Drug Facts, Marijuana and http://www.whitehouse.gov/ondcp/marijuanainfo for studies on harm caused by marijuana use.

Drug Courts

There are, at present, only six drug courts in Canada. This is in contrast to literally thousands of such drug courts in the USA.

Drug courts provide non-violent drug users with the option of obtaining treatment in lieu of conviction. That is, these courts provide a window of opportunity for the addict to obtain treatment, which the addict may not otherwise consider. It is significant that, whether the treatment is undertaken voluntarily, or by way of a court order, the rate of success remains the same.

It is significant that in the USA, 75% of drug court graduates remain arrest-free at least two years after leaving the program.[vii]; [viii] The National Crime Prevention Centre also reports that there is a significant decrease in drug use and drug related crimes for those who complete the court designated program[ix]. However, it is troubling that apparently only 14% of the participants of court-supervised treatment in Canada actually complete such programs.[x] Therefore, strategies are urgently required to encourage participants to complete treatment programs, as well as to greatly increase the number of drug courts established across this country in order to assist drug addicts.

[i] The Observer September 5, 2010 (UK)

[ii] US Drug Enforcement Administration Speaking Out Against Drug Legalization online at www.dea.gov, page 9.

[iii] Ibid.

[iv] Royal Canadian Mounted Police, Report on the Illicit Drug Situation in Canada- 2009.

[v] Dauvergne, “Trends in police-reported drug offences in Canada,” Juristat, Vol. 29, No 2, May 2009.

[vi] Ibid.

[vii] Roman et al, the Urban Institute and Caliber, “Recidivism Rates for Drug Court Graduates: Nationally Based Estimate-Final Report,” Washington D.C., 2003.

[viii] Department of Justice, Backgrounder (2 June 2005).

[ix] Public Safety Canada, National Crime Prevention Centre, Building the Evidence – Evaluation Summaries, “Drug Treatment Court of Vancouver (DTCV),” 2008-ES-18.

[x] Ibid.