Posted: March 31 2016
Author: Victoria Sinclair
Former Teenager with Heroin Addiction Says Measuring Health Impacts Must Be Central to Evaluating Drug Policy
My descent into addiction began as a teenager. I experienced trauma early in life and was raped in my sophomore year of high school, which took a toll on my mental health and led to using drugs as a means of escape. At 15, I started abusing alcohol and experimenting with drugs, and by 18, I had developed a chronic addiction to heroin and had varying levels of dependency on street stimulants and ketamine.
Over the five years I spent seeking treatment, my family and I encountered a seemingly endless series of obstacles – from programs that couldn’t accommodate me, to waiting lists that lasted much longer than my desire to get clean – all of which combined to feel like the treatment system was designed for me to fail.
As a young woman with multiple diagnoses and a history of trauma, I quickly discovered that the treatment services available were laughably insufficient for my needs. More than once, I was deemed ineligible due to my eating disorder diagnosis, and was even terminated from a program when my struggles with self-harm came to light. Given that mental illness is regularly accompanied by a co-occurring substance use problem, the fact that most programs can’t accommodate concurrent disorders is a serious problem.
Since the treatment options I needed were so scarce, I spent a large part of my teenage years in hospitals or psych wards with people much sicker than I because entry to any government-funded program was prefaced by a six to seven month long waiting list. I thought the waiting would be over once I was in the program, but after detox, I learned that the second phase wouldn’t begin for another two weeks.
When you’re an addict and you’re only coping mechanism is using, two weeks may as well be an eternity. I quickly realized that practicing abstinence from inside the security of a locked ward is nothing like practicing outside, where all the stressors and demands of life await you. And, if you’re addicted like I was, there is a good chance that your life is also chaotic and rife with conflict and toxic associations. Throw constant cravings into the mix, and maintaining sobriety for even two weeks becomes a Sisyphean feat.
The increased risk of fatal overdose following any period of abstinence means that waiting isn’t just gruelling and inconvenient, it can also lead to death. Like so many others with opioid addiction, I relapsed countless times while waiting for treatment. I’ll never forget waking up in an ER to be told that I had almost died. A stranger found me unconscious, and through a collaborative effort between the officers who arrived just as I lost vitals and paramedics who administered miracle-drug naloxone, my overdose was reversed and disaster averted. Had naloxone been administered even one minute later, I would not have survived and been given the chance to turn my life around. That’s why I was shocked to learn that the first people to arrive at the scene – police – aren’t equipped to administer naloxone in Toronto.
I was fortunate enough to survive my overdose and overcome my addiction. My family and I, and thousands of families like ours across Canada, experienced how destructive addiction can be. In those times, all my family cared about was helping me find treatment that worked, and keeping me alive in the meantime. We thought that these goals would align with the top priorities of our federal drug policy. Yet over the years, it became glaringly obvious that our national drug policy was failing to put the health of people with addictions at its core.
As the recent open letter from the International Centre for Science in Drug Policy outlines, Canada and the majority of other countries have prioritized a small set of indicators, such as the number of drug-related arrests and seizures, to evaluate drug policy. My family and I learned firsthand that in a world of finite government dollars, measuring success based on how many people are using drugs or how available they are comes at the expense of other more important priorities – like making sure we have enough addiction treatment beds for people who need them, or judging success on the number of drug overdose deaths we are able to avoid. “What gets measured, gets done,” as they say. Police never seemed to be under resourced when it came to carrying out arrests for drug possession – which I experienced time and time again – but that stood in stark contrast to health services.
Adopting the health indicators recommended in the open letter – including level of coverage for evidence-based treatment for substance use disorders, incidence of fatal overdose, and level of access to naloxone among people who use drugs – would be a meaningful step forward in aligning Canadian drug policy with the concerns of affected communities. We must also take the recommended metrics a step further by specifically measuring and prioritizing the availability of treatment options for people with co-current disorders, and increasing accessibility of naloxone among law enforcement.
Until we adopt new indicators focused on keeping people with addictions alive and helping them get sober, drug policy will continue to fail to meet community needs.
Victoria Sinclair no longer worries about getting her next fix. She has been clean and sober since October 2014 and is enjoying her renewed lease on life. This year she graduated from York University where she earned a bachelor in Psychology, rediscovering that life comes with it’s very own natural highs. These days she finds solace in yoga, meditation and long-distance running. She volunteers her spare time working with youth who use substances, and is involved in numerous campaigns for mental health, social justice and the environment.
This blog post originally appeared as an article on Huffington Post.