We’ve had wars on poverty and wars on crime and wars on drugs with the latest battle subtitle, the war on Fentanyl and all, sadly, with minimal results in spite of the billions and billions of tax dollars directed to law enforcement and health budgets. Data from emergency departments, coroners’ offices and rehab facilities to name a few obvious sources indicate a flawed and failed process. In science, one must ask the correct question before seeking the factual solution. We need to address the big picture and so the fundamental question is WHAT constitutes an addiction?
The working definition of ADDICTION is a persistent compulsive and accelerating dependence on a behaviour (examples gambling, shopping/spending, eating, some types of promiscuity) or substance misuse including alcoholism, smoking and drug abuse prescription or street, and a corollary there are no rules limiting the dependence to one type or category. Once the reader comprehends the extent of the problem and accepts the reality that socially accepted addictions such as alcohol and tobacco are as capable as opioids of producing fatal outcome, the next aspect of the question… the WHY…becomes explainable. Every human brain has pleasure centers. We seek rewards. Sadly, for reasons not yet fully understood, some of these pleasure centers in some people are hard wired to engage in ever riskier behaviours
Addiction carries a 50 BILLION dollar annual cost to the Canadian economy with 1/3 coming from the use of health care resources, 1/3 crime related damages to support the habit and crime prevention and court/incarceration costs, and 1/3 indirect costs in lost wages, lost productivity, injury under the influence etc. The explanation of HOW we reached this failure point rests with the closing-the-barn-door-too-late mentality which results in the misdirection of resources. By grade 8, more than 50% of adolescents have tried alcohol, 40% have tried smoking and 20% have flirted with marijuana. More recent data suggests the male dominance of these risk behaviours is now being matched by the other gender. Couple that with data on child drug abuse and accidental overdose– an indication that first exposure resides in the overstocked home medicine cabinet– you begin to understand why our misdirected resources are being wasted by not addressing the genesis.
FENTANYL? Fentanyl is just the latest hiccup. Yes, its an opioid 100 times more potent then morphine and yes, it is cheaper but more important, analysis of seized contraband shows 70% of the products are not as claimed at point of sale and/or contain toxic mixtures unknown to the user.
It’s time to redirect our resources. Stop incarcerating substance USERS. Mandatory treatment and long term follow-up monitoring (because there will be relapses) would be more proactive. Build non-hospital base treatment facilities in adequate numbers. Begin fundamental substance and behaviour risk knowledge classes in grade 1 and add progressive content with increasing maturity. Don’t worry that just talking about drugs will pique their interest. Their classmates have already done that. Also, we need to legally and license censure the minority of prescribing physicians who have lost their way and forgotten the direction of the doctor to patient relationship. Every pharmacist knows who they are. Abuse of pharmaceuticals begins with abuse of the prescribing privilege. There are effective and safer protocols for pain management than long term analgesics.
Save the resources of the legal process for the importers, manufacturers and sellers of illegal substances. My question for the Crown Attorneys is this: when the pusher knowingly adds a proven lethal substance to another illegal substance not disclosing the content and then sells it for the sole purpose of profit, why is that not a mandatory attempted murder charge?
Too many expensive fingers in too many expensive dikes is not the workable solution.
Written by: Dr. David Carll