There appears to be a growing consensus between the two dominant poles of politics in British Columbia. The Conservatives and the BC NDP have together embraced a series of regressive policies as the provincial election devolves into a surreal fantasy land where up is down, left is right, but somehow right is still right.
This whiplash shift in the Overton window began when the BC NDP caved to political pressure and ended their decriminalization pilot project halfway through its run time. Later, they caved to pressure from the right, and abandoned life-saving harm reduction vending machines providing discreet access to disease-free supplies, along with other harm reduction necessities listed on the website of the regional health authority. Finally, the latest surrender to conservative pressure has been the promise to, once again, force people who use drugs into “treatment.” Whether it’s authentic consensus or political cowardice, the right and the so-called left appear in lockstep on how to address these life-and-death issues.
The latest endeavour of this Craven Coalition is to snatch all the people off the street who use drugs and jail them, allegedly for their own good. It’s “treatment,” after all! Of course, the province can’t send anyone to regulated or public drug and alcohol treatment centres because in British Columbia there aren’t even enough beds for voluntary clients. While dedicated mental health facilities and hospitals are equally over-capacity, I suppose jails were chosen through a process of elimination.
The BC NDP assures us that prison guards or wardens won’t be administering these units, but rather licensed medical professionals. Given the dearth of medical professionals across BC, it is unclear where these licensed medical professionals will come from. In reality these will still be locked units with security personnel – and it sure won’t be an ambulance bringing in the new inmates!
So far the BC NDP proposal comprises a new mental health unit inside Surrey Pretrial Centre and a mental health facility built at the Alouette Correctional Centre in Maple Ridge. Following the overall policy creep toward recriminalization, the BC NDP is choosing to meet the public health emergency that was declared in 2016 with the full force of the carceral system.
I worry that when people hear about voluntary treatment, they think it works like an antibiotic: you party too hard over the weekend, catch a smidge of an addiction, you take some penicillin as prescribed, and it clears right up! The reality of voluntary treatment is closer to therapy.
If addiction treatment were akin to a medical antibiotic, enforcement might seem less excessive. If someone stubbornly refuses their dialysis, for example, they’re often assessed as “incapable,” forced into medical procedure to forestall organ failure, then sent back into the world. The coercive fantasy seems akin to a brief intervention that measurably prolongs a life through medically-sound practices. This brief intervention model is not, however, what voluntary alcohol and substance use treatment looks like.
I worked for a couple of years in a licensed treatment centre, and continue to work as a social worker with people who use drugs. In my experience, treatment is less like an antibiotic and more like therapy. Treatment centres typically have programs like art therapy, music therapy, trauma-informed yoga, group therapy, one-to-one counselling, Cognitive Behavioural Therapy to help establish healthier links between thoughts, feelings, and actions, Dialectical Behavioural Therapy to help regulate overwhelming emotions, and so on. A pattern is beginning to emerge here!
I truly believe that if John Rustad ever learns how much social and emotional learning goes into substance use treatment, he would abandon the whole project. Going into a bed-based treatment centre means going into a 90 day therapy session. These sessions are lengthy because patients are often working through lifelong trauma. In my experience, people often use drugs to cope with that trauma. Drugs are the treatment that people with addiction use to help them live with their debilitating trauma. These facilities exist as 90-day therapy sessions to provide education and training on alternative coping skills to the numbing and euphoric effects of drugs – quite tempting when sobriety is a living hell.
The reason these facilities are not always effective is because loss of control around drug use manifests itself over years or potentially decades, accumulating compounding trauma throughout the process. Keep in mind, trauma is not a singular event like growing up in a physically abusive household. Trauma can come from entrenched poverty, emotional neglect, or unpredictable safety and security.
This is why struggling to control drug use is often linked to colonialism, homophobia and anti-trans bigotry, and other forms of systemic oppression; trauma is the unhealed scars from all the awful things that can happen to a person. Three months of therapy before returning to the same environment that spawned trauma is unfortunately not always the “cure” for substance use issues that people want it to be. Remember, people have to leave treatment when they’re done. If those people are being taken off the street, where does the BC NDP intend to send them once their “treatment” is complete?
If the BC NDP thinks forcing people who use drugs into therapy is a good idea, I would invite David Eby to tell his wife, “Just calm down!” the next time they’re having an argument and report back on how well it went. There is a reason that 99% of treatment facilities are unlocked: people need to want to be there. The idea is to regain control of your life, and taking away that agency at the outset is so obviously counter to the therapeutic process that it makes me wonder if the BC NDP actually knows any more about substance use treatment than John Rustad.
Abducting people off the street, forcing them into jails, telling them this is for their own good – all of this is going to add to their trauma, not reduce it. Calling this “treatment,” as though it were a reasonable option among other available resources, is going to terrify and deter people struggling with their substance use away from getting any kind of legitimate help. Rather than bringing people into evidence-based drug treatment and recovery, the result will be to drive people further from the care and services they need.
Who is all this for? This anti-therapeutic model was clearly not designed with people who use drugs in mind.
Involuntary care gained some recent traction in the political discourse in light of a series of articles about a 13-year old girl struggling with her mental health while living at youth centre, before tragically dying after using the unregulated drug supply after fleeing to an encampment. Why leap to coercion? Why not promise improvements to the foster care and respite systems? Why not promise additional supports for families so that kids don’t end up in care? Why not promise additional funding to Child and Youth Mental Health services to cut down on wait times to see a therapist or psychiatrist? Where was this young girl supposed to go when she completed this involuntary panacea, and why would we think that the factors that contributed to her tragic situation in the first place would have resolved themselves in her absence?
This provincial election is an embarrassment. It tirelessly recycles the tough-on-crime mantra: ignore all the complex reasons that the scary thing is happening and instead warehouse the scary people so that they’re out of sight and out of mind. If we can stoke people’s fears and promise simplistic solutions to resolve them, we’re sure to win!
We desperately need to do better. We desperately need to actually look at the evidence when trying to address personal substance use issues, and start addressing trauma and the systemic causes of marginalisation. The BC NDP loves to claim that they are the party that looks to the evidence when developing policy. But given their sea-change on drug policy, this is clearly no longer the case. If there are any politicians remaining who are capable of feeling shame, I hope it haunts them for years to come.