© Guardian photo by Heather Taweel
Lynn Bradley and Wade MacRae of the Native Council of P.E.I. speak to MLAs on the provincial Standing Committee on Health and Social Development. The committee is holding public hearings on the issue of prescription drug addiction in P.E.I.
Editor: I have been following the media’s coverage of the public hearings on drug addiction and drug abuse with a great deal of interest and more than a little concern. As a physician with a special interest in chronic pain and addictions, I am well aware of the problems caused by the indiscriminate use of illicit drugs, the use of prescription medications for purposes not intended by the prescriber, and the ravages of tobacco and alcohol. We should keep in mind that the personal and societal costs of alcohol and tobacco misuse far outweigh the costs of illicit use of drugs, including the use of prescription drugs for illicit purposes.
I have heard many references to personal stories of death and destruction caused by misuse of drugs, but, unfortunately, have seen very little research substantiation of the scope of the problem and, whether. In fact, the prevalence of drug abuse and addiction on the Island has changed much over the past 10 years. Prevalence is defined as the number of people in a population who have a condition, usually expressed as a percentage of the total population.
If you do a search on “Dr. Google” and ask the question “what is the prevalence of drug addiction on P.E.I., in Canada or in the United States?” you will not find an answer, because nobody knows for sure. You will find statistics on drug dependence and abuse in the 2011 U.S. National Survey on Drug Use and Health produced annually by the U.S. Government’s Substance Abuse and Mental Health Service Administration (SAMHSA) and reports on Canadian drug and alcohol use and harm (CADUMS, 2011). Interestingly, the Canadian statistics, which are broken down by province, are replete with statistics withheld because of high variability in the data analyzed, read not trustworthy.
If you can believe what is reported in CADUMS, Prince Edward Island falls in the lower half of drug use and harm when compared to other provinces, and has done so since national statistics started to be collected in 2004. Unfortunately, there is very little information reported about P.E.I., presumably because those responsible for gathering health information haven’t addressed the particular issue of drug abuse and addiction or, heaven forbid, haven’t analyzed and/or shared this information with other agencies nationally.
What I have gathered from an extensive review of the literature is that drug abuse and addiction are serious problems on P.E.I., but not more so than anywhere else. According to available information, addiction and abuse have been with us forever; only the drug of choice at the moment changes and is highly dependent on availability, cost and cultural acceptance. The abusive drugs of choice today are alcohol, nicotine, caffeine, marijuana, opiates, stimulants and tranquilizers.
The “war on drugs” in the U.S.A. and Canada is an abject failure. All it has succeeded in doing is driving drug usage underground, improved the financial lot of a whole bunch of people with vested interests and afforded an additional employment opportunity for law enforcement agencies, the prison system and the drug rehabilitation industry, all of whose ranks have expanded exponentially across North America since Richard Nixon declared the U.S Government’s “War on Drugs” in 1971 and we started locking up more and more drug users, but not their suppliers so much. We should ask ourselves, for what purpose? Incarceration does nothing to decrease the prevalence of drug abuse or addiction in the community.
It is a weak deterrent, at best, and a terribly expensive one to boot. People who suffer from drug abuse and addictions do need our help, and simply incarcerating them in a brief detox program, as exists today at Mount Herbert, is inadequate. Ongoing outpatient rehabilitation is essential to recovery, especially for those who have become addicted. Twelve-step programs are more effective for drug abusers and not as successful for those people who are suffering from the brain disease of addiction, a chronic disease which acts the same way as other chronic diseases like diabetes, coronary heart disease, waxing and waning over the years, but never being “cured”.
If we are serious about decreasing the incidence of drug abuse on the Island we will need to identify and clarify our objectives and to develop a realistic plan to implement such a strategy.
Maybe the plan already exists in the currently unreleased government document on drug addiction and mental health, but we won’t know until we get a chance to read it. We may never solve the problem of drug abuse and addiction, a long-term issue which seems to afflict about eight per cent of the population, as best I can gather by extrapolating from available information.
The majority of these are non-addicted drug abusers and more amenable to deterrence and cure.
I am worried that government committees, comprised of members lacking professional knowledge of the subject matter being discussed, will precipitously develop public policy in the absence of enough objective evidence to make a reasoned rather than an emotional decision.
By Dr. Desmond Colohan
Special to The Guardian
Dr. Desmond Colohan is a P.E.I. pain medicine physician with a special interest in addictions and responsible public policy.