Opioid crisis needs treatment not harm reduction, says addiction specialist

As Ontario earmarks over $200 million to battle the opioid crisis, some doctors say this money should go directly to treatment, not harm reduction.
'My worst fear now is getting denied recovery.' says Jonathan, an addict desperate for treatment, not only harm reduction. He tells CBC reporter Amanda Pfeffer taking methadone is not enough. (CBC)
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For the past two weeks, Matthew St. Jean has been trying to secure a detox bed for 24-year-old Jonathan.

St. Jean is a volunteer working at a safe injection site in an Ottawa park where he has been seeing Jonathan routinely.

But Jonathan wants more than just a clean needle. He wants to get better.

"I'm young, you know? I just don't want to waste my life, I guess," Jonathan tells CBC's Amanda Pfeffer.

My worst fear now is getting denied recovery.- Jonathan

Jonathan was raised by his grandmother in Thunder Bay, Ont. He started taking pills when he was 15.

"My childhood was a long and depressing childhood, I guess. That's what kind of started the whole thing," he says.

He's taking methadone now but says what he really wants is treatment and recovery.

RelatedA space to shoot up, but no space for addiction treatment

However, there are only 26 detox beds available in the city of Ottawa.
Matthew St. Jean volunteers at a safe injection site run by Overdose Prevention Ottawa. (CBC)

"[It's] very frustrating, especially since you have someone who wants to do the right thing for their life and try and get better, and the resources aren't there," says St. Jean. 

Jonathan says he knows what it's like to be clean and methadone alone won't be enough to get him back there.

"My worst fear now is getting denied recovery. The only thing I'm looking forward to is to get clean now," he says.

Without help, Jonathan tells Pfeffer, he'll "probably overdose."

"I'll gradually get worse, I'll probably die."

'Treatment of addiction and mental health is essentially non-existent'

This past summer, the province of Ontario announced $222 million in new funding — with $2.2 million going specifically to Ottawa for treatment and harm reduction. 

Rich people get treatment. Poor people get harm reduction — That's it.- Dr. Mark Ujjainwalla

But complaints are emerging the bulk of spending to date has gone to harm reduction, leaving people looking for treatment in the lurch.  

Addictions medicine specialistDr. Mark Ujjainwalla, blames the Liberal government for the lack of treatment options. In fact, he goes so far as to say that "treatment of addiction and mental health is essentially non-existent in 2017."

Dr. Mark Ujjainwalla equates supervised injection sites as palliative care for people with drug addictions. He wants to see more funding go towards treatment instead of harm reduction. (CBC)

"[The Liberals] are essentially telling everybody that the treatment of addiction is injection sites," Dr. Ujjainwalla tells The Current's Anna Maria Tremonti.

"People in Ontario and Canada have been sold this idea that the treatment of addiction is to continue injecting drugs, and basically you're hopeless and you have a medical illness, but there's no medical treatment."

RelatedAddictions doctor calls for treatment in Ottawa instead of supervised injections sites

Dr. Ujjainwalla equates supervised injection sites as palliative care — "or, in some levels, an assisted suicide."

He argues treatment and dollar signs go hand in hand.

"Rich people get treatment. Poor people get harm reduction — that's it," Dr. Ujjainwalla tells Tremonti.

"There's not one new residential treatment bed in Ottawa since the 70s. In fact, there's less."

We have a total patchwork of harm reduction services across the country.- Donald MacPherson, director of Canadian Drug Policy Coalition 

Canadian Drug Policy Coalition directorDonald MacPherson agrees there's a real problem with the coherent treatment system in Canada. 

"But it's not either/or, you need both — and harm reduction is a part of the treatment system."

He argues the Ontario budget spends a significant amount on mental health and addictions.

"Where that fails is ... when you don't have the right amount of investment in the right places."

Researchers have been working to create vaccines to fight drug addiction. So far, most are being tested only on animals. (Shutterstock)

Related: 'You're trying to solve a drug problem with another drug': Vaccines for cocaine, heroin and opioid addictions

Supervised injection sites are well-studied and cost-effective interventions, says MacPherson, but "that does not mean that is the only way to go and no one is arguing that."

The fact that, in 2017, treatment systems are not evidence-based is "preposterous," according to MacPherson.

"We have a total patchwork of harm reduction services across the country," he says.

MacPherson adds that, while harm reduction gets the most attention, there's not much of it out there.

"You're talking about a tent in a park in Ottawa that's run by volunteers. Now, come on: that's not a real widespread comprehensive approach to this problem. "

Listen to the full segment near the top of this web post.

This segment was produced by The Current's Lara O'Brien, Kristin Nelson, Ashley Mak and Yamri Taddese.