Jason Howell speaking about a recovery orientated system of care in Texas, he is a person in long term recovery from both mental health and substance use issues. This new approach, this recovery system of care is sometimes called ROSC, for an acronym and it’s really looking at If we believe that addiction is a chronic illness then why isn’t our health system and our general system treating it as such. We spend so much of our energy and so much of our money in an acute care system. Detox can be lifesaving treatment; 20 days at least can be stabilizing but we really should be looking at how do we support someone in long term recovery. With any other chronic illness, we’re looking at supporting somebody for five years before we say that they’re in remission and a person in recovery from substance use disorder might need to have the same intensity of service. How do we create a network that allows them to have their recovery journey? That’s what a recovery system of care is. It’s also looking at building on strengths and resilience of the individual, the family and community.
One thing Texas did with the Health and Human Services Department is they bought a concept of a recovery system of care and then they launched a several years plan. It started out with quarterly statewide meetings, getting leadership together and talking about the concept, forming local community ROSC, those individuals would then go back and start talking to their community. It’s bringing in the recovery community it’s bringing in schools it’s bringing in the criminal justice system. I would say a system moving to a recovery system care is a process as well. Harm reduction is part of the concept for a recovery oriented system of care. I won’t say that we’ve come to 100 percent consensus but that we respect each other and are gentler with each other.
If we can engage with them in research showing that if you can have a personal connection with someone and stay connected with them as we do here in the states in Texas we have what they call sobriety centers, instead of sending them to jail. When the window of opportunity happens and somebody is ready or even wanting to try and we get them connected with that the help that they need.
Jason is in America it’s a little bit different than Canada but I think we’re still fighting for the same purpose same reasons and are still affected by an overdose crisis as well.
Travis Lupik, a reporter for the Georgia Strait, and author of the book, “Fighting for Space”
Since the financial crisis really picked up, the downtown east side is pretty much become my full time beat for the Georgia Strait. I became interested in the downtown east side because of living here and the overdoses picked up and as a member of the community it became impossible to ignore how many how many people were dying. I was waiting for my bus to work, there was a body with a sheet over it next to me, then coming home later a different evening walking by EMT responding to an overdose.
I love this neighborhood though. It’s a community that takes care of itself and that’s really something I tried to highlight in the book. Vancouver’s been through something like this crisis before a lot of people will remember in the mid 1990s early 2000s when we suffered through Vancouver’s first overdose epidemic and similar what’s happening today. I felt as we head into another crisis that it might be time to recount that story. I think there is a connection of the AIDS virus epidemic in the 80s & 90S and addiction because I remember people blamed people with AIDS like they deserve it, how they did it to themselves, we still hear some of that. That treatment was too expensive, to save peoples lives, that has changed now, and I hope we move in the same direction with addiction.
Two amazing women, Liz Evans who founded the Portland Hotel Society and Ann Livingston who co founded the Vancouver Area Network of drug users. They started off on their mission separately but their paths crossed over the next couple decades. They said we’re going to start involving drug users in drug policy. A revolutionary idea. Liz Evans with the Portland Health Society said we’re going to give people a home and that home is going to be unconditional, the tenants were told this is your home now and this is always going to be your home, you’re not getting kicked out. Give people a home and then you let them work on the rest of their issues.
Abstinence based recovery and harm reduction is complimentary, but abstinence is quite obviously the best way to go. No drugs are better than drugs but not everybody is ready for no drugs and you want to keep them alive until they are ready for no drugs, especially an opiate addiction. It’s become more challenging to keep people alive long enough to get abstinence. I think harm reduction is really got to be a part to allow people to get there.
Treatment is incredibly expensive. You need dedicated buildings full time staff and our provincial government has shown for a long time now it is not willing to invest in treatment. The overdose prevention site just across the street from here was running for months on a go fund me page. They stole electricity from the bank next door and they ran on a few hundred dollars a day. I wrote a book about harm reduction, but with 1400 people dying a year now people should be absolutely screaming for a plan for treatment in British Columbia. It’s hard to get people to the point where they want into treatment, when they do get to that point we don’t need to make it this damn hard