ADDICTION SHOULD BE TREATED AS A DISEASE, NOT AS A MORAL FAILING

The traditional view of addiction, and one that stills holds
considerable sway, is that addiction is a moral failing, a failure of
the addict to muster up the willpower to cease destructive behaviour.

In a paper released last week, the British Columbia Medical
Association challenges this view, and suggests that addiction is, and
should be treated as, a disease rather than a personal failure.

Now, one can debate the definition of "disease" and whether
addictions rightly fit that definition. But there is no question that
many people with substance abuse problems can be aided by medical
treatment, and that governments (and the medical profession), perhaps
influenced by the traditional view, have underemphasized addiction treatment.

The result of this failure to take addiction seriously can be seen on
the streets of Vancouver, particularly on the Downtown Eastside. But
not just there: Addiction is also a hidden illness, as it also
affects many people who live in "nice" areas, with homes and families.

Indeed, an estimated 400,000 British Columbians suffer from some form
of addiction, and that number doesn't include addiction to tobacco or
prescription drugs. According to a six-week study conducted last
year, as many as one in 10 visits to Vancouver General Hospital was
for substance abuse.

Across B.C., more than 48,000 hospital days were attributed to
substance abuse, which is enough days to fill Kelowna General
Hospital every day for a year. Sadly, many people aren't lucky enough
to recover in hospital: In 2006, 213 British Columbians died from
unintentional illegal or illicit drug overdoses, 77 committed suicide
by alcohol or drug poisoning, and 1,986 died alcohol-related deaths,
including 914 seniors.

Clearly, substance abuse, and other forms of addiction, such as
gambling, cost a fortune in terms of human suffering. But they also
cost a fortune in dollars: In 2002, the price of substance abuse was
estimated at $6 billion ($1,500 per British Columbian.) This figure
includes direct costs such as health care and law enforcement, and
indirect costs such as disability, insurance and absenteeism.

Given this steep price, we ought to do whatever we can to reduce the
damage done by addiction, and the the BCMA makes 10 recommendations
to accomplish that goal.

In addition to formally recognizing addiction as a disease, and
thereby treating it much like we treat cancer or diabetes, the report
recommends the development of 600 new addiction beds by 2012 (150 a
year) and the creation of 240 new detox spaces, also by 2012, to
ensure detoxification is available on demand.

The report also advises the elimination of per diem fees for
addiction treatment. Although it's not widely known, long-term
residential patients can face fees of $90 a day, something that makes
treatment unattractive or impossible for many. One can only imagine
the outrage if cancer patients were forced to pay similar fees.

Finally, the report makes a series of recommendations concerning the
expansion of addiction research and improved training of physicians
in addiction medicine. Approval of a proposed Centre for Excellence
in Addiction and Concurrent Disorders could go a long way toward
satisfying these recommendations.

Health Minister George Abbott has said that the province agrees with
the recommendations and is working on formally recognizing addiction
as a disease. That's a good start, and now we must ensure that
Victoria follows through on the rest of the recommendations.