"British Columbia's prison system has become a health and addiction system of last resort, according to a new study from SFU , which found that three-quarters of people admitted to B.C. prisons in 2017 suffered from addiction or mental health issues — up from 61 per cent in 2009. Complex care cases — people with a combination of addiction and mental health needs — more than doubled in the same time period, from 15 to 32 per cent. That’s approximately 10 times the national average, estimated at between two and four per cent."

“This is a multiple systems failure that we’re seeing,” said Amanda Butler, lead author of the study. “I think a lot of these folks have been failed by every other service system before they come into contact with the criminal justice system.”

Damning indictments indeed, but it’s the Why, and the Wherefore that must be investigated, if we are going to attempt to remedy this growing, and seemingly, uncontrollable mess.

Many interpretations will be gleaned from this very concerning emergence, and depending on one’s confirmation bias metric, finger pointing will go in many directions.

One perspective we'd like to bring to this, is one that is all too often quickly buried by the pro-drug hijackers of 'Harm Reduction' models.

As we have written time and time again on this issue, Harm Reduction (an important pillar in drug policy) is supposed to be about minimising short- and long-term harms to the drug user, WHILST enabling, equipping, and empowering them to EXIT drug use! Hmmmm? Since the sector charged with reducing the harms of drug use (including not just the 'harms' to the drug user) have stopped focusing on drug use exiting, the harms have only increased. 

One of the foundational causes of this ever burgeoning chaos, is of course, DRUG USE.  If one doesn’t use drugs, the harms do NOT occur! 

Ah, but I hear the vociferous objections of the stakeholders in this failing misuse of policy; 'That's over simplifying the situation, the reasons behind drug use are complex'. 

Now, we start the 'spelunking' of the social determinants. Social Determinants 19-08-21b.pdf (dalgarnoinstitute.org.au) this malaise.

There is no argument from us that there may be many catalysts for initial uptake, but once drug using starts, the substance then becomes one of the key drivers to drug seeking behaviour, if not the sole one, once dependency presents.

A ‘circuit breaker’ in the drug use/seeking behaviour is an imperative. If ‘Harm Reduction’ mechanisms, do not have a ‘circuit breaker’ in its arsenal in the fight against this individual and community destroying behaviour, then it continues to fight this insidious foe with one hand tied behind it’s back.

‘Liquid handcuffs’ (substance substitute options) https://nobrainer.org.au/index.php/search-our-site?q=liquid+handcuffs&Search=  can be part of a ‘circuit breaker’, if and ONLY if, the clear and scheduled cessation of drug use is the immovable goal.  Yet, all too often, we see this potential vehicle for exiting drug use only become another individual undermining chemical dependence.

So, when all the syringes have been handed out. All the drug consumption rooms have been engaged. All the free chemical substitutes have been administered… and drug use continues, and grows, then where does a community go in the longing to free these slaves to substances, and the heart broken casualties that are their family, friends, and colleagues?

The failed misused policy ends up where British Columbia finds itself. The only ‘circuit breaker’ remaining is ‘secure welfare’ – which in almost all cases is interpreted as the prison system.

Sadly, the incarceration is not just the exasperated last resort for the recalcitrant drug user, it’s also what the drug use has led to, that so often facilitates criminal proceedings. Everything from acquisitional crime to violence, public nuisance or other society impacting ripple effects from this distressing behaviour.  

When you’re dealing with a (more often than not) intractable life controlling issue, coercive vehicles are needed to start the change process. To quote the now famous recovering addict, Actor Robert Downy Jnr, “It’s not that difficult to overcome these seemingly ghastly problems [drug addiction]… what’s hard is to decide to do it.” 

Pity, it is said looks at a problem superficially and throws a token ‘kindness’ at the issue and walks away. Compassion, however, insists on restoration, not just ‘recalibration’, and therefore cannot condone a ‘kindness’ that doesn’t only not end the grief, but adds to it.

When the ‘Judicial Educator’ – the law – is employed for this compassionate end, then seemingly punitive responses, are transformed to restorative ones, and coercion is used not to bring retribution, rather restoration, we see a proactive outcome for all involved. (see https://www.dalgarnoinstitute.org.au/advocacy/dalgarno-aod-policy/1597-prisoners-graduate-from-unique-addiction-breaking-program-at-casuarina.html )

Yet, there is perhaps still one more unfolding in this sad saga – and an arguably cynical one at that, but bear with us.

What if the agenda of the gatekeepers of the ‘harm reduction’ policy have little to no regard for the cessation of drug use? Instead, they seek only to sanitize and normalise drug use? Create a tsunami of substance use behaviour that simply can’t be ‘managed’ by criminal justice, or now even ‘health policy’. It can only be allowed to exist un-impugned, simply tolerated.

Sadly, we have dealt with such stakeholders and their well-masked agenda.

When a society becomes enamoured with the pursuit of pleasure, that it now perceives even ‘failed entitlements to ‘happiness’, normal vicissitudes of life, or even emotional inconveniences, as trauma that need to be ‘medicated away’ with the ‘buzz of the gear’, you know that public health and well-being policy is in trouble – as is the community and its families it is charged to serve.

Shane Varcoe

75 per cent of people sent to B.C. prisons struggle with addiction, mental health: study | Vancouver Sun

(#RecoveryIsPossible from #liquidhandcuffs if effective chemical free rehabilitation is applied) The ‘damage management’ and short-sighted approach of Opiate Substitute Treatments, cares little for the rehabilitation of the addicted individual, if there is no ‘sunset clause’ on the process. Medically Assisted Treatments, may be useful only as an initial circuit-breaker to dependency, but is not a long-term health benefiting option. (Some people are now going to Narcotics Anonymous to get off Methadone, after being heroin free for 14 years)

For complete article

(Dalgarno Institute Comment – Medically Assisted Treatment or Opioid Substitute Treatments are not a long-term solution, and the sector knows it. In fact, these treatments are causing increasing harms in and of themselves, both unto addiction, as well as physiological and biological harms. If drug use exiting outcomes is not the goal and all vehicles employed to help the dependent individual exit drug use – including the imperative of ‘sunset clauses’ on the use of MAT’s, then ‘harm reduction’ becomes a ‘harm enhancer’. (See Combining Medications With 12-Step Model Treatment Improves OUD Outcomes) These failed policy practices continue to be largely left unscrutinised (at least in the Australian context), as a more ‘set and forget damage management’ model, and this is both unacceptable as a public health outcome and an individual recovery outcome)

Dopamine along with other chemical messengers like serotonin, cannabinoids, endorphins and glutamine, play significant roles in brain reward processing. There is a devastating opiate/opioid epidemic in the United States. According to the Centers for Disease Control and Prevention (CDC), at least 127 people, young and old, are dying every day due to narcotic overdose and alarmingly heroin overdose is on the rise. The Food and Drug Administration(FDA) has approved some Medication-Assisted Treatments (MATs) for alcoholism, opiate and nicotine dependence, but nothing for psychostimulant and cannabis abuse. While these pharmaceuticals are essential for the short-term induction of “psychological extinction,” in the long-term caution is necessary because their use favors blocking dopaminergic function indispensable for achieving normal satisfaction in life. The two institutions devoted to alcoholism and drug dependence (NIAAA & NIDA) realize that MATs are not optimal and continue to seek better treatment options. We review, herein, the history of the development of a glutaminergic-dopaminergic optimization complex calledKB220 to provide for the possible eventual balancing of the brain reward system and the induction of “dopamine homeostasis.” This complex may provide substantial clinical benefit to the victims of Reward Deficiency Syndrome (RDS) and assist in recovery from iatrogenically induced addiction to unwanted opiates/opioids and other addictive behaviors.

For complete research

Media release

Fifty-two prisoners have graduated from a unique new rehabilitation program at Casuarina Prison designed to break the cycle of addiction to alcohol and other drugs that so often leads to criminal behaviour.

The nine-month program, called Solid Steps, was developed by the Department of Justice in conjunction with external service providers the Palmerston Association and Wungening Aboriginal Corporation.

It is the first residential alcohol and other drug rehabilitation program to be delivered in an adult male prison in Western Australia.

Department of Justice Director General, Dr Adam Tomison, said breaking the cycle of addiction is critical to improving community safety in the longer term.

"Solid Steps aims to deliver a holistic program which enables prisoners to reduce their alcohol and drug dependence by developing strategies and skills to address risky, harmful and destructive behaviours that lead to poor choices and criminality," Dr Tomison said.

"The program is based on a culturally safe, modified therapeutic community model. It also strengthens connection to self, family, culture and community."

Just over 40 per cent of the program’s participants are Aboriginal.

Solid Steps is delivered five days a week by trained health experts, counsellors and support staff.

Dr Tomison said support for the program graduates continues beyond the prison.

"A comprehensive through-care framework has been developed to support the participants’ recovery journey, whether they are transitioning back into the community or remaining in custody for now," Dr Tomison said.

"There's no sugar-coating the reality that breaking addiction to alcohol or drugs is hard – really hard – and it isn’t always achieved on the first attempt."

Dr Tomison said by investing in programs like Solid Steps, the Department of Justice hoped to drive recidivism rates down.

"If we can help the vast majority of Solid Steps graduates stop using alcohol and drugs and they then don’t commit any more offences, that’s a win-win," Dr Tomison said.

"There’ll be less people being harmed and less people as victims of crime. And these men will be leading more productive lives, which is really important for them and their families, and overall it’s going to be cheaper for the community."

One participating prisoner, a Noongar man who cannot be identified for privacy reasons, said he volunteered for the Solid Steps program after spending the past 20 years in and out of the justice system.

"It’s the longest I’ve been clean in the past 10 years and my confidence has grown every day that I can say no to drugs because I know what I’ve got in life, I know everything I can be thankful for in life and I don’t want to lose all that because I go down that same path of drugs and crime again," he said.

The Solid Steps program continues at the Mallee Unit with rolling intakes every four to six weeks.

Prisoners graduate from unique addiction-breaking program at Casuarina (www.wa.gov.au)