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(*Not In Anyone's Back Yard) "V.P.D. recommendation: A mental health care facility that can accommodate moderate to long term stays for individuals who are mentally ill -with disabling conditions, extreme behaviours, no permanent housing and regular police contact"
-- Lost in Transition, Vancouver Police Report, endorsing the need for institutionalized care for the severely mentally ill who are also criminals. Jan 2008.

Spend more. Make things worse.

How often have you been told that "the solution" is to spend a lot more money on addiction treatment programs?

In 1998, the UK (United Kingdom) 1 launched the National drug strategy 2, the cornerstone for tackling problematic drug use. A massive increase in funding expanded treatment and as a consequence waiting times for addiction treatment were significantly reduced.

As we, in Vancouver are now embarking on a similar strategy, let us look at how effective is the UK national drug treatment strategy.

Results: In NW England outcome data on effectiveness shows that despite spending a lot more money, and engaging a lot more addicts in treatment the addiction treatment industry managed to cut their success rate (drug free at discharge) by more than 1/3rd and they actually decreased the number of people successfully treated (drug free at discharge) 3.

Spend more; make things worse.

Aren't Vancouver taxpayers continually told that the solution is to spend more on addiction treatment?

NW England "is the only area of the UK that has consistently collected treatment outcome data 45 on all clients of drug services annually since 1996." 6 The treatment outcome to measure a drug treatment program's effectiveness is drug free at discharge (stopped using drugs and/or alcohol). Let's look at their drug free at discharge from treatment outcome results from 1998 to 2002.

Year Number Addicts in Treatment Discharged drug free % discharged Drug Free
1998 7594 443 5.8%
1999 7261 718 9.8%
2000/01 8166 360 4.4%
2001/02 8061 281 3.4%

(X2 trend=128.45, P<0.0001) 7

pie chart 3.4%

3 to 4 addicts out of 100 addicts were clean and sober after addiction treatment in NW England in 2001/2002. 8

Increasing capacity of drug treatment programs in the UK has actually made things worse. We are planning on doing the same. In 2005 and 2006 BC had 21,538 people accessing publicly funded alcohol and drug treatment services 9. There is no meaningful monitoring or measuring of the effectiveness of current addiction treatment programs in British Columbia.

This is why NIABY does not support any large supportive housing or treatment facilities for drug addicts in residential neighbourhoods. Dismal addiction treatment success (drug and alcohol free) rates put communities at risk and squander scarce health care dollars.

Published August 28, 2008.

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1 United Kingdom = England, Scotland, Wales and Northern Ireland.
2 National Drug Treatment Strategy
1. Massively increased additional funding for expanded addiction treatment and large reduction in waiting times for addiction treatment.
2. Specific treatment for stimulant addiction (cocaine, crack cocaine, crystal meth) were established.
3. Measures implemented to encourage drug-using offenders to participate in treatment.
4. Launched in 2000 the Arrest Referral Initiative, a scheme which placed addiction treatment counsellors to refer the addict to treatment services.
5. Increased the number of addiction treatment counselors from 6794 in March 2002 to 10,106 in September 2005.
6. Drug Courts
3 Benyon C, Bellis M et al "Trends in drop out, drug free discharge and rates of re-presentation: a retrospective cohort study of drug treatment clients in the North West of England." BMC Public Health, August 2006 6:205
4 Structured treatment services such as substitute subscribing (methadone), structured counseling and abstinence based services. Did not include needle exchanges, drop in exchanges.
5 It is extremely rare to get good quality data measuring % drug free at discharge in addiction literature. You can view this paper at www.biomedcentral.com/1471-2458/6/205 www.biomedcentral.com/1471-2458/6/205
6 Benyon C, Bellis M et al "Trends in drop out, drug free discharge and rates of re-presentation: a retrospective cohort study of drug treatment clients in the North West of England." BMC Public Health, August 2006 6:205
7 Benyon C, Bellis M et al "Trends in drop out, drug free discharge and rates of re-presentation: a retrospective cohort study of drug treatment clients in the North West of England." BMC Public Health, August 2006 6:205
8 Benyon C, Bellis M et al "Trends in drop out, drug free discharge and rates of re-presentation: a retrospective cohort study of drug treatment clients in the North West of England." BMC Public Health, August 2006 6:205
9 Kieltyka, M "Finding a new path" 24HRS.ca November 26th, 2007 P4

Articles - September 8, 2010
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