NIABY.COM

(*Not In Anyone's Back Yard) "..as using drugs or consuming alcohol, even at low levels, is associated with a range of adverse consequences including higher rates of non-adherence, relapse....aggression, incarceration"
-- Psychosocial interventions for people with both severe mental illness and substance misuse (Review) Cochrane Collaboration 2008

Advocates Corner

Arguments in favour of drug addict "Abstinent-Contingent" supportive housing.

Over the past 2 years, NIABY has received many emails from advocates in the mental health and addictions treatment industries. We appreciate hearing from everyone, including those who are passionate advocates for drug addict treatment and housing. In the paragraphs below, NIABY presents the some of the suggestions and solutions we have received advocating in favour of large drug addict "Abstinent-contingent" supportive housing and treatment programs. Our reply then follows.

"You are Nimby. You lack compassion. You are evil. You are ... (numerous other slurs)."

You resort to name calling because you cannot prove with science that "abstinent-contingent" drug addict supportive housing works. The science shows that most of these drug addicts will use drugs again even during treatment. The inability of most of the drug addicts to stay off drugs even during treatment 1 means neighbours' concerns about their safety are real and not trivial.

"NIABY is being selective on what medical literature you post. You only post bad results. There is overwhelming evidence that drug addict supportive housing is effective."

Exactly where is this "overwhelming evidence" of effectiveness? Send us this evidence and we will post it. Stop saying that there is overwhelming evidence of effectiveness unless you can provide it. Your good intentions and opinions are not evidence.

"These abstinent-contingent drug addict supportive housing facilities are needed throughout the city. If it's thoughtfully built and managed carefully it will work."

This implies that all the current science reporting dismal results from abstinent-contingent supportive housing was done in poorly managed treatment programs and poorly planned facilities. Prove these supportive housing facilities work - provide conclusive scientific studies before you build more. Show us your carefully measured results based on drug testing. Publish them on your websites.

"The drug addicts are motivated and seeking treatment. They will stay off drugs."

Because you wish it so does not mean it will happen. It has been shown in studies that even though addicts are seeking treatment and are motivated, most will quickly return to using drugs. 2
"Indeed, individuals (drug addicts) may seek and self administer drugs even while consciously resolving never to do so again".3 American Journal of Psychiatry, August 2005.

"There are addicts everywhere including your neighbourhood. They need help."

We agree. The proposed community treatment programs and housing options should have convincing evidence of effectiveness (sustained abstinence, getting and keeping a job) and safety (no negative impacts on community). For facilities and supportive housing already in operation, there should be strict annual auditing of each facility for the "metrics" of effectiveness and safety by an independent auditor, not City of Vancouver, other government bureaucrats or the Non Profit agency/provider. The results from the effectiveness audit should be posted on the Non Profit's website. Sites failing to demonstrate effectiveness should be closed or repurposed with meaningful consultation with the host community.

"Every neighbourhood needs to do their fair share."

No neighbourhood, anywhere in Vancouver should have this abstinent-contingent large supportive housing model for drug addicts or drug addicts with a mental illness. Science shows it doesn’t work therefore there is a real risk to community safety from relapsing drug addicts. We shouldn’t be building large supportive housing apartments that have been shown to not work. (Safety – Yours and Mine »)

"We must do something!"

We agree! But why do something that doesn’t work? Current science shows drug addicts return to drug use of greater than 70% at 6 months. Vancouver City Hall hired numerous medical experts and consultants to scientifically prove to the taxpayer that abstinent-contingent addict supportive housing would eliminate drug use and be safe for the neighbours. City Hall couldn't prove anything except that drug addicts will use drugs and alcohol in large numbers in this so called "abstinent" supportive housing.

Revised April 2, 2008.

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1 John Moore University, Centre for Public Health, Faculty of Health and Applied Social Sciences, Liverpool. Khundakar et al “Drug treatment in the North West of England 2006/2007” ISBN 1-902051-90-4
2 Kertesz, Mullin et al, "Long-Term Housing and Work Outcomes Among Cocaine-Dependent Homeless Persons", Journal of Behavioral Health Services and Research, Dec 2006.
3 Hyman S, "Addiction: A disease of Learning and Memory" American Journal of Psychiatry Vol 62 8 Aug 2005.

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City of Vancouver,
Mayor and Council

#310 - East Tower, 555 West 12th Avenue, Vancouver, BC V5Z 3X7
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Colin Hansen, MLA
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Rich Coleman, MLA
Minister Responsible for Housing
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Coast Mental Health
Non-profit Housing Provider for 16th & Dunbar info@coastmentalhealth.com

Dr. David Marsh
Addiction Medicine Specialist, Vancouver Coastal Health
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Cameron Gray
Director of Housing Centre, City of Vancouver
cameron_gray@city.vancouver.bc.ca