Government Paradigm Shift Needed For Addiction And Mental Illness

Carol Mackie, Salt Spring Island, BC

This letter was first published in the Salt Spring Exchange, December 16, 2016

I am a Salt Spring Island-based mother of one of the over 622 people who have died from (primarily) Fentanyl overdoses in 2016 in our province alone.

I also am the mother of an adult son struggling with a mental health disorder. Both my children had the benefit of a loving, supportive and economically-secure home with parents willing to spend whatever it took to get them help.

The problem is that Canada simply does not have effective mechanisms in place to provide the kind of assistance that the most vulnerable among us desperately need.

What we need is a complete paradigm shift when it comes to helping Canadians with addictions and mental illnesses. Please let me share with you why I have come to believe that this is absolutely critical.

On July 6, 2016 I found my beloved daughter, Kate, splayed over the side of her bed: cold, hard and with a bluish/blackish mottled face. She had been dead for several hours. The on-site coroner and attending RCMP officer concurred that the scene had all the markings of a heroin overdose.

It took over 3 months for her toxicology report to arrive, thanks to the huge backload of Fentanyl-driven demands on the only lab on the B.C. mainland that handles coroner toxicology reports. There was no heroin in Kate’s system, only Fentanyl, a drug that my daughter specifically steered clear of as it had almost killed her once before in Calgary.

My daughter had been an addict since age 13. Very few treatment options existed then (or now) and all were designed exclusively for the wealthy. The two very expensive long term residential programs we tried had abysmal success rates as did the various short term free treatment programs. But what other choices did we have? About the same choices that my adopted father had when he unsuccessfully sought help for his alcoholism when I was a child growing up in the 50s.

With drug addiction comes the need for cash, which leads to crime, which leads to jail. Kate went through this vicious cycle and came out the other side. She got clean and was paying her debts to society. She moved to Salt Spring Island earlier this year at age 31 to start a responsible, hard-working and much beloved new life with me.

Unfortunately, as in so many B.C. and other Canadian locales, opioid addiction is big business on Salt Spring Island. Between the backyard chemists mixing up and pressing their own pills, the counterfeit drugs flowing in from Asia, and the money-strapped folks selling their prescription opioids on the street to supplement their incomes, we have a huge, unaddressed problem here.

Relapse is a part of addiction and Kate was not immune.

When my daughter relapsed and sought her drug of choice, heroin, she had no trouble finding someone who would charge her for heroin but, unbeknownst to her, sell her the much cheaper Fentanyl instead. When she inhaled what she thought was a maintenance dose of heroin, she was killed instantly by the far more powerful Fentanyl.

Is this not murder on the dealer’s part? If someone sold a lawyer an “all-natural” cookie laced with enough arsenic to be fatal, I’ll bet that someone would be charged with murder. Why aren’t dealers - trying to profit by selling a cheaper, deadlier drug for a more expensive one - not being held accountable for murder?

No alert was issued island-wide after Kate’s death that Fentanyl was being passed off as heroin to our children and neighbors. Her many friends, co-workers and loved ones were left with no answers and certainly no solutions. I have since heard via the medical community of more unreported Fentanyl deaths on Salt Spring Island. Why aren’t warnings being shouted from the rooftops by police, health officials, social workers, pharmacists, etc? Or as a society, are we really okay with this kind of silent carnage? Please ensure that the answer to this troubling question is “no.”

Let’s talk about common sense solutions, some of which are admittedly Band-aids while others require systemic change.

On the systemic change front, it is imperative that as a civilized society, we stop punishing people for their illnesses and start helping them to live productive lives in spite of their afflictions. For this to happen, the boondoggle that is the racist, U.S.-led “War on Drugs” must end. How much more proof is needed of its abject failure? It is time for Canada to show real leadership and break with this incredibly destructive “war” that is tearing apart families, neighborhoods, communities and the very fabric of our nation itself.

  • Legalize all drugs. There is no other way to drag drug addiction out of the shadows, the prisons and the morgues. Take the power away from the street dealers/cartels/murderers and stop treating their victims like they deserve what they get.
  • Surely it is the government’s role to oversee the safe production and distribution of all drugs as they do with alcohol and tobacco. Sensible guidelines are expected but the Nanny State doesn’t work so our individual rights as citizens to make decisions about our own health and consumption must be respected. It is only when we cross the line to purposefully do harm to others via illegal drug manufacturing and dealing that the long arm of the law is needed to step in.
  • Use the tax money currently being squandered on drug enforcement and punishment and use it for addiction research and education which leads to proven and humane treatment methods.
  • Stop using police SWAT teams to “take down” the mentally ill, either by shooting/tasering them or dropping them off at overwhelmed hospitals or remand centres that take cookie-cutter approaches to medication. My 34-year-old son cannot handle any of the side effects of the medications for his condition. He therefore, is considered by psychiatrists as untreatable and is refused any help. The legal system was unable to complete two court ordered psychiatric assessments even though he was held for 4 months, moving back and forth between a forensic psychiatric unit and a remand centre. His sister, Kate, was the only person he trusted and is really the only person that has ever actually helped him cope with his illness. He is, once again, back in the forensic psychiatric centre and his cycle of doom continues.
  • The availability of the opioid antidote, Naloxone, or more accurately, the lack thereof, is one of those Band-aid approaches that nevertheless can save lives, unless an addict is alone and cannot self-administer, or the addict has been fed a brand-new designer drug that is Naloxone-resistant. That said - is there any legitimate reason why Naloxone is harder to find than Fentanyl? Why isn’t Naloxone standard issue for every Canadian police cruiser, every EMT kit, every Pharmacy, every walk-in health clinic, every legal shooting gallery, etc?
  • Also part Band-aid but necessary nonetheless is the banning of the unregulated sale of pill presses. Why make it easier for say, freelance research chemists to “break bad” by using their knowledge to make and press Fentanyl pills that then kill our loved ones? Making the over-the-counter ingredients of meth less easily obtainable in the U.S., for example, has cut down on the number of mom and pop meth cook labs with all the social, health and environmental nightmares that go hand-in-hand.
  • We were promised more treatment beds in B.C. We are still waiting while our children die. However, more treatment beds are only effective if effective treatments are being administered in them. We need to kick our national habit of classifying people with addictions and mental illnesses as less -than-human, castaways to be left to the fate they brought upon themselves through weakness of character. We must reclassify addiction and mental problems as illnesses - just like Parkinson’s disease, epilepsy and Alzheimer’s disease. Real dollars must be dedicated to thinking outside-of the-box to address addiction and mental illness. Surely, best practices from around the world could provide better solutions than we are getting right now here in Canada. Psychiatry also must undergo a major paradigm shift. Offering the same unhelpful solutions over and over and expecting different results is one definition of insanity, isn’t it?
  • Education is crucial to correct the many false assumptions and unhelpful, damaging, and discriminatory behaviour towards those who are afflicted. People who are not directly related to an addict or someone with a mental illness often don’t realize that there is much more to these folks than just their diseases. I have known a large number of addicts and many people with mental illness and most of them are or were kind, creative, talented and intelligent. My son, for instance, is very intelligent and excelled in math. He could work out the square of a 4 digit number in his head when he was 6 years old. He has a diploma from Loyola in electrical engineering and computer programming. Little good it has done him. My daughter was very much a people person. On Salt Spring Island, she was hard-working and well respected by staff and customers according to the owner of a building supplies company where she worked until her death.

The issue is that my addicted and mentally ill children aren’t the only ones. So many people have been failed miserably by our dysfunctional systems and not helped whatsoever. That is why we need to consider a whole new way of solving this enormously difficult problem and archaic, savage way of dealing with our sick and downtrodden.

The broken mechanisms currently in place for addiction and mental illness help next to no one. Not the addict and their families; nor the overwhelmed police, justice and healthcare systems; nor the frustrated taxpayer; nor the politicians who insist on keeping useless policies and an unjust system in place. It is the politicians who should ultimately be held responsible by an increasingly infuriated and ever-growing group of disgusted voters. It is the politicians who have the power to make the necessary changes . . . if only they can find the will and the courage.