Canada Drug Rehab

Cathy Patterson-Sterling, MA, RCC

Cathy Patterson-Sterling, Director of Family Services for the Sunshine Coast Health Centre, shares what she has found to be the most common mistakes people make in early addiction recovery.

By Geoff Thompson, MA, CCC
Program Director
Sunshine Coast Health Center

We can learn a lot about addiction and recovery from our current fare of drug prevention programs.

Here are some statistics: According to a 2007 published survey by the Government of Canada, most Canadian youth, aged 15 to 24, reported that they used illicit drugs. Only 39.7% said they have never used, 38% said they used only cannabis, and 23.7% said they used an illicit drug other than cannabis. Almost all youth reported using alcohol, and 82.9% in the last 12 months. Of past year drinkers, 13.8% reported getting drunk weekly and 40.6% at least monthly. (By the way, if there is such a thing as a ‘gateway drug’, then these numbers tell us that it’s alcohol.)

To combat these numbers, communities, schools, and parents spend a lot of energy trying to keep youth away from drugs and alcohol. Most prevention programs are simply local efforts, which have no basis in psychology research or practice. But both the US and Canadian governments tell us that many programs have been studied and have “scientific evidence” that they work. These programs generally use some basic psychology principles to help people learn how to say no, how to deal with peer pressure, how to deal with stress, how to deal with anxiety and depression, and so on.

The key to all these programs is that they point out that drugs are a poor way to deal with what makes us uncomfortable in life. And there are lots of things that make us uncomfortable. Booze is great if you’re going to a dance. It helps you get over shyness. Being intoxicated is a great way of dealing with boredom. Getting high is a great way of dealing with loneliness.

The problem with using drugs for this kind of uncomfortableness is that they can backfire. Having to rely on drugs every time you go dancing, for instance—and having to use more as time goes on because of tolerance—can lead to disaster.

Pointing out the risks involved seems entirely reasonable. But here’s the problem: Regardless of what program designers and governments tell us, top-of-the-line research has shown that our current prevention programs don’t work very well.

It’s important to remember that Bill W., the driving force behind the development of the 12 steps, also understood the benefits of using. He said that intoxication is a substitute for satisfying the urge for wholeness and connection with God. In 1943 at the Shrine Auditorium in LA he told the audience that the alcoholic was a person who was looking for religion in a bottle. But, of course, seeking fulfillment through intoxication always backfires, leading to great suffering.

In this article we’ll explore prevention programs to see why they are not very successful. Knowing this can help you understand the power of drugs and what you or your loved one will likely have to do to recovery from addiction.

Part One — Our Current Approach to Prevention: “Drugs are bad”

Drug prevention programs operate according to the principle that “Drugs are bad, so don’t use them.” Typically, they tell us that using drugs will inevitably cause any number of problems. Studies of the effects of drugs on the brain, physical deterioration of the body, lost jobs, depleted finances, broken families, risk of arrest and incarceration, and so on are marshaled up to convince people to abstain. And many programs invite recovering addicts to tell their story to young people about how drugs destroyed their lives.

It all seems like a good way to keep young people away from drugs. Unfortunately, this approach doesn’t work very well.

Many big-shot researchers have studied the “evidence” of programs that claim to be successful — the ones that the US and Canadian governments have said were scientifically proven to be effective. The researchers discovered that the “evidence” was not very good.

For example, four of the most famous prevention programs are Strengthening Families, Life Skills Training, Project ALERT, and DARE. Researchers examining the evidence for Strengthening Families and Life Skills Training wrote: “Far from supporting the evaluators’ claims concerning the rigour of the findings and their generalisability and public health significance, the results were very fragile, of little practical significance and quite possibly analysis-dependent.” What this means is that the so-called “evidence” that the program worked did not meet basic research standards. Other researchers studied the evidence behind Project ALERT and DARE and found that these programs were of little or no value.

Part Two — Problems with the “Drugs are Bad” Approach

It seems so reasonable to try to stop people from using drugs by telling them all the dangers. And the dangers are not little: lost families, major health problems, lost jobs, mucking up the brain chemistry. And there is the real possibility of death.

But there are a growing number of experts in the field, who are showing why this “drugs are bad” approach is not very effective in preventing drug use. Here are some of their reasons:

1) Prohibition doesn’t work — The idea that drugs are bad is based on, as one researcher said, “the persistence of prohibition as an ideological force.” What this means is that trying to scare people into abstaining is based on ideas of the prohibition movement that helped make drinking illegal in the United States in 1920 and in Canada in 1918. You probably know that prohibition did not work. It was based on a moral stance and not on any scientific understanding of human nature.

2) People don’t believe the message — Surveys of school kids exposed to the “drugs are bad” message have shown that they don’t believe it. They know kids who have used crystal methamphetamine and who didn’t end up in the emergency ward of the hospital. They know kids who use substances and are straight-A students. They know athletes who smoke marijuana. They know kids who get drunk at parties, and the most they seem to be affected is a hangover the next day.

3) Kids like to take risks — One of the pleasures of teenagers is to take risks, including doing things that are illegal (small things, mainly). There’s an excitement involved. A drug prevention program that displays illegal drugs is likely to inspire more curiosity than fear. Interestingly, when addicted famous people talked to kids about drugs, the kids usually thought they could do drugs and then clean up — just as these celebrities did. (By the way, when researchers discovered this, they stopped asking famous people to talk to kids about drugs.)

These are just a few examples; there are many more. But they show that perhaps our current drug prevention programs are wrong-headed.

Part Three — New Research on Prevention

A handful of researchers, knowing that current prevention programs do not work very well, have said that we need to re-think the logic that we use to try to prevent drug use.

Most of these researchers are in England, but a growing number are in Canada and the United States. For example, British researchers have been studying why young people in Britain use ecstasy and ketamine. They have discovered that many young people find positive benefits from intoxication.

The idea that intoxication has rewards is not new. The great psychologist and philosopher William James (the guy who impressed Bill W. so much) was convinced that being drunk or stoned helped the user connect with the universe, find insight into perplexing problems, and generally feel more energized and alive. And, of course, some of the great addict-writers, such as Thomas De Quincey, Samuel Taylor Coleridge, William S. Burroughs, Eugene O’Neill, and Jack Kerouac said more or less the same thing.

Young people we’ve studied have told us that using ecstasy and ketamine at dance clubs has helped them connect with others in a positive way. They even tell us that they have found long-term benefits of being more empathic (the ability to appreciate what others are feeling).

The second thing they tell us is that intoxication allows them to connect with something greater than they are. In previous articles I’ve talked about how people can feel a sense of belonging while under the influence. Researchers in the United States have studied 18 to 24 year olds who experience the benefit of ecstasy as “transforming the everyday.” The researchers concluded that ecstasy highlights “the extraordinary or transcendental nature of the experience.”

Part Four — Drug Prevention has to Account for the Benefits of Drugs

Modern drug researchers have come up with a “new” idea. As one researcher put it, “Research has failed to explore a significant and integral feature of drug use, primarily the reasons why people use and the benefits they receive.”

People use because they find some rewards for getting intoxicated. Researchers have concluded that we need to understand these benefits if wide are to design drug prevention programs that work. In fact, one researcher has pointed out the obvious: The reason why our current drug prevention programs don’t work is precisely because the benefits that users tell us they get from being intoxicated make them resistant to programs that are based on the approach that “drugs are bad.”

Here are some of the rewards that users have told us about substances: (1) “Alcohol is great for dealing with shyness,” (2) “ecstasy can make you feel closer to others,” and (3) “heroin makes everything okay even when my world is falling apart.” Young users of dextromethorphan tell us that it aids in creating a trans-personal experience. This trans-personal experience means that that intoxication moves the user beyond paying attention to himself and puts him in a state that is beyond time and space.

So, this is good information for you to know as part of how to stay away from drugs and alcohol. If the benefits of intoxication are this feeling of community and this trans-personal experience, then it makes sense that you will have to figure out how to find a sense of belonging and how to finding something in life that makes you feel alive.

This is, of course, the entire purpose of the 12-step program. And it is one of the main themes of addiction treatment at Sunshine Coast Health Center.

Cathy Patterson-Sterling, MA, RCC

Cathy Patterson-Sterling, Director of Family Services for Sunshine Coast Health Centre, shares why it is so important to have a strong after-care plan and support network after addiction treatment.

By Daniel Jordan, General Manager
Sunshine Coast Health Center

It is often easy to overlook the damage alcohol causes in our society since, unlike other drugs like cocaine, it is legal. Alcohol continues to be encouraged as a social “lubricant” in our busy world as a way to unwind or to have fun. However, as Emergency Services prepares to gear up for another high school graduation, perhaps it is time to review some important statistics about the alcohol-related health and social harms in BC and Canada.

Types of Harms Related to Alcohol

According to the BC Provincial Health Officer, alcohol-related health and social harms derive largely from four properties or effects of consumption:

1. Toxicity - alcohol poisoning (overdose)

Death from acute cardiac arrhythmia or acute pancreatitis. More often than not, alcohol overdoses affect the inexperienced drinkers who tend to be under age.

2. Intoxication - injury or crime

Death or injury resulting from violence, sexual assault, crime, alcohol-involved traffic casualties, etc.

- According to the BC Injury Research and Prevention Unit, approximately one-quarter of the 400+ fatal motor vehicle crashes that occur every year in BC are alcohol-related (Rajabali & Pike, 2008).

- According to a 2002 study (Pernanen, Cousineau, Brochu, & Sun, 2002), one-third of all crimes, charges, and prison sentences in Canada involve alcohol.

- A recent study by the Canadian Medical Association Journal showed that more than 21 per cent of sexual assaults are facilitated by drugs, up from 12 per cent in 2003. While this is a huge increase, an equally important finding from the Canadian Medical Association Journal research is that almost 90 per cent of these victims had used alcohol before the attack.

- Deaths due to toxicity (poisoning) and intoxication (injury)combined accounted for 2.7 per cent of all deaths in BC between 2001 and 2005 (Source: BC Alcohol and Other Drug Monitoring Project).

3. Dependence - alcoholism

Long-term excessive use of alcohol is directly linked to cirrhosis of the liver, some types of cancers, diabetes, hypertension (high blood pressure), brain damage, and wasting of the limb and heart muscles.

- In a 2002 Canadian Community Health Survey, 3.6 per cent of the BC population (122,400 people) were estimated to be alcohol dependent.

- There is a strong correlation between heavy alcohol use and mental health conditions, such as major depression and anxiety disorders. It is estimated that 1.3 per cent of Canadians age 15 and older (approximately 336,761) reported experiencing co-occurring major alcohol use and mental health disorders in the previous year (Rush et al., forthcoming).

- Deaths due to chronic drinking accounted for 2.1 per cent of all deaths in BC between 2001 and 2005  (Source: BC Alcohol and Other Drug Monitoring Project).

4. The Intergenerational Effect of Alcohol - Fetal Alcohol Spectrum Disorder (FASD)

A fourth source of harm that involves alcohol is alcohol consumption by pregnant women. Fetal Alcohol Spectrum Disorder, or FASD, is the leading cause of preventable mental disability in Canada. FASD is unique in that the harm inflicted is to the unborn fetus rather than to the alcohol-consuming individual or other members of society. Estimates are for every 1,000 babies born up to 3 will have the full features of FASD, while an additional 5 or 6 will have significant long-term disabilities. In BC, between 200 and 320 infants may be born affected by alcohol each year (Provincial Health Officer, 2002). A substantial protion of the costs of special needs education, youth justice, adult incarceration, homelessness, and adddiction can be attributed to FASD (Provincial Health Officer, 2002).

Conclusion

The ripple effect of alcohol in Canadian society is revealed in the statistics. According to the 2004 Canadian Addiction Survey , 10 percent of Canadians reported at least one harm during the past year from one’s own drinking (age 15+) and nearly 4 in 10 reported at least one harm * during the past year from others’ drinking (18+).

At our treatment center, alcohol is still the drug of choice for over three-fifths of our clients. For those whose drug of choice is cocaine, alcohol is often their second drug of choice. Even though we don’t treat for date-rape drugs since few develop a dependence to them, our date-rape drug section accounts for four of our top 10 search terms for people visiting our Sunshine Coast Health Center website. We believe there is a need for public education on how alcohol is a factor in sexual-related assaults.

Hopefully, Canadians will begin to appreciate that there are many ways to get hurt, directly or indirectly, from alcohol. One does not need to develop alcoholism to be negatively impacted. This message needs to be conveyed to high school students who often have a very narrow understanding of the harms associated with alcohol.

(*) Note: Harms associated with others’ drinking include (1) being insulted or humiliated (22.1%), (2) verbal abuse (15.8%), (3) serious arguments or quarrels (15.5%), (4) being pushed or shoved (10.8%), (5) family or marriage problems (10.5 %), and (6) being hit or physically assaulted (3.2%).

Source

This blog article is a summary of Public Health Approach to Alcohol Policy: An Updated Report from the Provincial Health Officer issued in December 2008 by P.R.W. Kendall, Provincial Health Officer. 

Dedication

This blog is dedicated to Richie Dowrey who is in grave condition in hospital following a punch to the face from a fellow patron at the Fountainhead Pub on Davie Street in Vancouver on St. Patrick’s Day. Richie was punched without warning or any apparent reason. Richie has two children. Our prayers are with him and his family for a speedy recovery.

References

Du Mont, Janice; Macdonald, S.; Rotbard, N.; Asllani, E.; Bainbridge, D.; and Cohen, M. (March 2009)
Factors associated with suspected drug-facilitated sexual assault
Can. Med. Assoc. J., 180: 513 - 519 ; doi:10.1503/cmaj.080570

Pernanen, K., Cousineau, M., Brochu, S., & Sun, F. (2002) Proportions of crimes associated with alcohol and other drugs in Canada. Ottawa, ON: Canadian Centre on Substance Abuse.

Provincial Health Officer (2002) Public health approach to alcohol policy: a report of the Provincial Health Officer. Victoria, BC: Ministry of Health Planning.

Rajabali, F., & Pike, I. (2008) Alcohol-related motor vehicle crash deaths in British Columbia: 2003-2005. Vancouver, BC: BC Injury Research and Prevention Unit.

Rush, B., Urbanoski, K., Bassani, D., Saulo, C., Wild, C., Strikes, C., et al. (forthcoming) Prevalence of co-occurring substance use and other mental disorders in the Canadian population. Canadian journal of psychiatry.

By Cathy Patterson-Sterling, MA, RCC
Director of Family Services, Sunshine Coast Health Center

 The “make sure you look both ways before you cross the street” safety talk, the “Birds and Bees” and “where do babies come from talk”, and, of course, the dreaded talk about alcohol and drugs are a sampling of the many milestone talks that we will have with our children as they grow up through the years. For many of us as parents, the alcohol and drug talk can be one of the most challenging. The following includes five tips parents may wish to keep in mind that, besides the “don’t do drugs” talk, will help keep their kids safe from the harms associated with drugs and alcohol:

Tip #1: Be mindful of your relationship with alcohol/drugs/mood-altering substances

Remember that children’s greatest influence is their parents and parents are likely the first people to introduce to their children the meaning of alcohol and drugs by using substances themselves or through their comments. Therefore parents should be mindful of the meaning substances have in their lives such as: “I need a cigarette,” “Oh no! I’m out of coffee! I guess my morning is shot,” or “What a day! Someone get me a Tylenol.”

Tip #2: Teach your children to work through their feelings

Addicted individuals do not believe they can function without alcohol and drugs. Such people are “numbing feelings,” “escaping pain,” and “mood-altering in order to feel good.” Parents need to help their children understand that feelings are normal and need not be overwhelming. Furthermore, the problems or thoughts that created these undesirable feelings will still be there when the effects of the mood-altering substance fade away.

Tip #3: Allow your children to experience consequences and learn from their mistakes

In life, we as people will make good decisions and mistakes. We need to experience consequences for our decisions so that, depending on the outcome, we repeat or avoid making the same decision the next time.  There are natural consequences for all of our decisions in life. As parents, we can help our children reflect on their decisions at each stage so that they learn to take responsibility for their behaviours. This critical thinking skill will be necessary for when they go through the teenage experimental years and are exposed to drugs/alcohol.   

Tip #4: Teach your kids self-preservation

People do not have to be addicts or alcoholics to die from booze and drugs. Many do so by accident, particularly youth. Drug and alcohol use can easily become a self-destructive activity especially if people are drinking/using drugs in excess and are making poor decisions such as driving while impaired. Statistics show that many deaths and harms associated with drugs and alcohol are committed by accident by the inexperienced drinker or drug user (i.e. fights, car crashes, falls, poisonings, etc.) *. As parents, we can teach our children to practice self-preservation by taking care of themselves and making personal safety a priority.

(*) Source: Public Health Approach to Alcohol Policy: An Updated Report from the Provincial Health Officer (December 2008) P.R.W. Kendall, OBC, MBBS, MSc, FRCPC

Tip #5: Connect your children to positive activities

Youth with dreams, goals, and a sense of belonging will move more quickly through the stage of experimentation with alcohol/drugs. Essentially, drugs and alcohol are “dream-stealers” and youth need to know that if they stay in this alcohol/drug mis-use stage long enough that they will depend on substances to cope in life as they slowly start to give up on more ambitious goals for themselves.

Conclusion

By practicing these five tips at home, parents can begin to plant the seeds of prevention where kids will naturally start to make the right choices. Parents need not concern themselves with becoming experts or worry that their past experimentation with drugs or alcohol will make them sound like hypocrites. By being a positive role model, expressing concern for their safety and health, and involving them in positive activities, parents can help insulate their kids from alcohol- and drug-related harm.