VICTOR WANTS THE FULL TREATMENT

Hi Mensche:

This city needs a dialogue on treatment; maybe a Langara dialogue.

I am tired of the obfuscation.

On a daily basis I hear bloated talk show hosts admonish us because treatment is not available for addicts. But they never define or discuss treatment.

Similarly, newspaper columnists bring the scientific weight of their two-year journalism diplomas to the call for treatment. But they never define it. Never analyze the efficacy of any treatment protocols.

I am tired of being preached to by these moralizing intellectual sophomores.

We need a dialogue around the following question:

TREATMENT: WHAT WORKS ?

WHAT DOES ' IT WORKS' MEAN?

WHAT WILL IT COST?

Question one.

With respect to question #1, surely we have the right to put the treatment regimens under the bright light of scientific scrutiny. We do this for every other health issue. So what works? The question is particularly important given the claims by VCH that treatment can be effective for dual-diagnosed addicts. OK? The procedures manual for the Psychiatrists Association lists 300 mental disorders. There are a dozen different addictive drugs at least. That's thousands of combinations. Do we use the same 'treatment' for all of them? Does the manic depressive addicted to heroin et the same treatment as the violent cocaine addict? Who gives the treatment? Somebody with an undergrad degree in sociology? What is the regimen? Yeah, I know, psychiatrists are scorned, even though they have medical degrees, but given that addiction is a health issue, dare I ask for the credentials of treatment advocates? And if addiction is not a health issue, but a lifestyle issue, get it away from my taxes. I don't pay for botox failures.

Question Two.

What do we mean by" treatment works"? Does this mean the 34 year old meth addict stays clean for 2 years? One year? Gets a job? Who defines success? Every six of months or so I stop shaving for 4 days, put on my garden clothes and walk East Hastings. Try it. I get away with it because I am a cripple and I limp badly. I ask myself whether any of the lost souls I encounter could ever cross over to civilian street. Could they clean up? Get a job. Eat right. Yes, I'm aware of the heartfelt stories about the ex meth addict who now sorts bottles at a charity. But we need to face the fact that even, and I stress, even of we clean up the estimated 7000 addicts in the GVRD, they will be on the dole for life. Bloated talk show hosts and columnists flog the notion that somehow, these denizens of despair will clean up, join the Rotary, wear sensible shoes and eat organically.

Assume society accepts the cost of cleaning all 7,000 dual diagnosed addicts. Surely we should discuss the cost of housing, feeding and caring for the bulk of them, and those who will replace them, in perpetuity.

Question three. The cost.

Everybody dances around this. I have only one number as a reference. The facility in Keromeos, the one that will "treat" (that word again) 40 addicts a year, has an operating budget of $2 million. That's operating costs of $50,000 per addict, not including capital costs. They claim a high success rate although, success isn't defined. (see point 2). But assuming the Keremeos facility "Works" that translates into $350 million a year for the 7000 addicts on the downtown east side. That doesn't include capital costs. Let's put capital costs for 7000 units at $150 million, which is a bargain.

So we have a figure of $500 million a year. (Plus support for the rest of their lives). That's before the WCF (World Crackhead Federation) descends on Vancouver for 2010.

Can we at least, as Charles Dickens said "do the sums".

God forbid all those earnest advocates puzzle their sincere minds with accountability.

But, it as been said, "Earnest is another name for Stupid that went to university."

v