Pubdate: Thu, 26 Mar 2009
Source: Vancouver Sun (CN BC)
Copyright: 2009 The Vancouver Sun
Contact: http://www.canada.com/vancouversun/letters.html
Website: http://www.canada.com/vancouversun/
Details: http://www.mapinc.org/media/477
Author: Kelly Sinoski

TREAT ADDICTION AS A DISEASE, MDS TELL VICTORIA

Health Care System Should Cover Alcoholics, Chronic Gamblers And 
Other Addicts, Bcma Says

B.C. doctors are calling for the provincial government to formally 
recognize addiction as a chronic disease -- and provide public 
funding to deal with it.

The call comes in a report being released today by the B.C. Medical 
Association that says more than 400,000 British Columbians suffer 
from some form of addiction.

These people are struggling to get help when they need it, the report 
says, because of a lack of resources or the high cost of treatment. 
This in turn puts strains on emergency departments, workplaces and families.

"For many years, addiction was seen as a personal failure rather than 
an illness," said Dr. Shao-Hua Lu, an addictions psychiatrist. "One 
tends to focus on the terrible losses in the Downtown Eastside, but 
in terms of overall cost, alcohol, gambling and tobacco probably 
costs society much more."

The BCMA says alcohol, gambling and drug addictions, which are often 
linked to some form of mental illness, are akin to heart disease and 
diabetes and the province should treat them the same way. While 
treating a gambling addict the same as a cancer patient would add new 
costs to the system, the BCMA argues it would ultimately save money 
by preventing the costly results of untreated addictions.

In 2002, the estimated cost of treating substance abuse in B.C. was 
more than $6 billion, or $1,500 per person per year, with alcohol, 
gambling and tobacco taking the biggest toll on society, said Lu, who 
is clinical practice director for the new Burnaby Centre for Mental 
Health and Addiction.

According to the report, one in 10 visits to Vancouver General 
Hospital's emergency room is for substance abuse, while B.C. uses 
enough hospital beds for substance abuse care to fill Kelowna General 
Hospital every day for a year.

The report suggests 120,000 British Columbians have a high 
probability of alcohol dependence, with 33,000 addicted to illicit 
drugs and 31,000 with a severe gambling problem.

The BCMA defines addiction as a treatable disease involving the 
repeated use of substances or behaviours despite significant and 
ongoing harms that outweigh the benefits.

To fill the gaps, the BCMA is calling for 240 detox spaces and 600 
new addiction treatment beds by 2012, as well as investment in 
treatment and infrastructure over the next five years. It also 
recommends government provide medical funding, community treatment 
centres, housing programs, standards of care for addiction, medicine 
treatment and more training for physicians in addiction medicine.

It also proposes the elimination of per diem fees for treatment. Lu 
noted that an alcoholic can attend Alcoholics Anonymous for free, but 
a person attending a long-term residential treatment facility could 
face a per diem of $90 per day. B.C. Womens' Aurora program's 
six-week intensive residential treatment program costs $2,730, or $65 per day.

The BCMA would like to see such financial barriers removed or covered 
under the Medical Services Plan.

"Imagine the same thing for cancer care," Lu said. "What we want is 
the government to step up and recognize this is a disease and we 
should treat this disease as we treat every other illness."

Health Minister George Abbott said he agrees with the recommendations 
in the report, noting that the ministry is already looking at 
formally recognizing addictions as chronic diseases.

"In terms of the direction of BCMA, we would be fully in agreement," 
he said. In these tough economic times, though, he said, the province 
is hoping to maximize the benefits of its health care dollars.

Abbott said there is a growing recognition among medical officials 
about the correlation of mental health to addiction and the province 
is looking to address issues around that in a 10-year mental health 
and substance abuse plan.

"I recognize it as a chronic disease now, especially when it's 
coupled with a mental illness," he said. "Some people do get over 
their addiction but others often need support for a long time."

He said the province is trying to address such addictions through 
investments for youth at the Crossings treatment centre in Keremeos 
and through other substantial resources.

"It's a big challenge, no question," he said. "There doesn't seem to 
be any indication that the area around addiction is abating."

Neither Lu nor Abbott would estimate the costs of providing the 
additional services. But both maintain society is already paying a 
price in terms of absenteeism in the workplace and problems on the streets.

Lu said the cost of the additional treatment depends on the program 
and the location, noting it's cheaper to provide services outside 
Metro Vancouver.

"In a time when we're going through financial difficulties and an 
economic downturn, we need to focus on treatment that will pay 
dividends. The vast majority of [addicted] are young, working people. 
They have a tough time stopping on their own. Willpower for a lot of 
folks just won't help."

The BCMA plans to do a separate report on tobacco addiction, which Lu 
said is still the No. 1 killer.

David Faust, a 41-year-old sex and cocaine addict, said help is 
available if you can afford it. He's bounced between treatment 
centres and is a new resident at the Baldy Hughes Therapeutic 
Community in Prince George, where he hopes to kick the addictions 
that have plagued him for decades.

"I firmly believe that addiction in general in our society is the 
ultimate epidemic," he said. "I''ve been down on Main and Hastings a 
lot over the years. Every time I go down there, you can count the 
number of people, the population, growing at an excessive rate."

The B.C. Gaming Policy Enforcement Branch declined Wednesday to 
comment on the report, called Stepping Forward: Improving Addiction 
Care in British Columbia. The branch already provides a 24-hour help 
line, as well as clinical counselling and problem gambling prevention services.
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MAP posted-by: Keith Brilhart