All MLAs fail Judge Orr’s challenge

Second Opinion by Paul MacNeill, publisher

In every way the mother of two was living a normal life. But somewhere along the line normalcy took a devastating turn for Tina Burke when the 36-year-old became addicted to prescription drugs. It led the former RCMP employee down a path of crime that ultimately landed her in front of Judge Nancy Orr.

For the frank talking Provincial Court Judge, Burke must have represented a boiling point. In her frustration at the growing epidemic of addicted Islanders appearing before her, she took the rare step of urging provincial MLAs to spend a day – pick a day, any day - in her court for a real world view of the impact drugs have on Islanders.

“Until we have the services and the resources we need to help people there will be more people like Burke in our courts … and more victims,” the judge said.

Sadly, the governing Liberals could barely hide their disdain at any suggestion they don’t already know everything there is to know about addiction.

“We know it’s a major issue, we know there’s no simple solutions. If she has the solutions, give them to us,” the premier acerbically told the Legislature.

Maybe Robert Ghiz missed Democracy 101, but the judicial branch is not intended to create solutions. That role falls to our elected officials.

And on Prince Edward Island the Ghiz government is failing to deal decisively with the growing epidemic of addiction and mental health issues.

A legislative committee recently patted itself on the back for delivering six recommendations that include the earth shattering ideas of a brochure to outline available addiction services and proclaiming Sunday September 7, 2014 as Recovery Day.

So, Liberal MLAs who dominate the committee think a day that allows them to wear some type of ribbon and issue press releases will actually do anything to reduce addiction, or improve treatment options on PEI?

That’s not leadership; it’s pathetic.

Like the premier, Health Minister Doug Currie scorned Judge Orr’s suggestion. Speaking to reporters the minister said he does not need to sit in a courtroom to understand the issue. “We’ve clearly embraced the conversation and the challenging realities of addiction,” he is quoted as saying.

There is no doubt Island MLAs hear horror stories of addiction. But that does not mean government’s ‘plan’ will make a dent in the issue. Currie is investing modest amounts in frontline treatment.

His primary response thus far has been to delay action and create more bureaucracy. His plan will only waste precious dollars and time.

A group of Charlottetown doctors spearheading a private methadone clinic made it clear that their investment is spurred on a by a desire to avoid meddling from mid-level health bureaucracy.

Humility is often lost on politicians and both Doug Currie and Premier Robert Ghiz proved that with their arrogant response to a judge on the frontline of the devastating fallout of addiction.

Photo ops, press releases, new bureaucracy and limited frontline service investment will not improve reality for the thousands of Islanders suffering from addiction and mental health issues.

Lest you think Liberals were alone in playing politics with addiction, Tories were not far behind. Almost immediately the party issued a press release proclaiming the three-member opposition caucus will take Orr up on her challenge. “It is in court where the connection between addictions and crime will be very obvious,” Health Critic James Aylward boomed.

But the issue is not pressing enough for the opposition to show up in a courtroom until some unknown date after the fall sitting of the legislature. It is more important for Tories to tell Islanders about their outrage rather than actually doing something about it.

And the issue is not pressing enough to convince Island Tories to criticize their federal brothers in Ottawa for closing the only facility in North America dedicated to researching the connection between addiction and criminality. No, instead PEI Tories sit quietly by and let the Addictions Research Centre in Montague close.

Addiction should not be a political ping-pong. Those suffering deserve real leadership, not arrogance and political opportunism. Instead what we witnessed from Liberals and Tories shames us all.

Paul MacNeill is Publisher of Island Press Limited. He can be contacted at paul@peicanada.com

 

Anonymous on Wed, 12/04/2013 - 11:00

Why not...

ADDICTIONS

The problem with synthetic opiates in PEI is obvious across Canada and the United States. When Purdue pharmaceuticals applied for a patent to exclusively market 'OxyContin' (oxycondone), they failed to properly warn of the 'dependence liability' to the regulatory bodies, the Federal Drug Administration (FDA) in the US and Health Canada. Dependence liability is the measurement of the risk of forming a biochemical dependence on this drug. The regulatory bodies allowed for open marketing of these drugs and as a result, we are encountering the fallout of this failure of disclosure. The good news is that Purdue has been successfully litigated for misrepresentation and fraud and has paid out hundreds of millions of dollars in restitution. The bad news is despite this restitution, there are still people who are physically dependant on these drugs. Please note dependancy differs from addiction. Addiction is said to be a psychological issue rather than a somatic issue. Someone can be addicted to something but not dependant, and be dependant and not addicted. These two issues demand different conceptualization and treatments.

At any rate, the problem with these drugs is that they are allowed to be sold. There is and was no good reason to allow for this and when Purdue applied for the generic version to be allowed in Canada, the Federal government chose to allow for it despite the evidence demonstrating that these drugs cause more harm than benefit. This is because of a massive drug lobby and bad science supporting the claim that these drugs are 'safe'. Overall, this was a mistake in regulatory policy that has yet to be undone. (How regulatory bodies function is a massive medico-legal argument and outside the scope of this post).

If you care to blame anyone for 'why' we have problems with addiction in the case of synthetic opioids, you can go ahead and blame Purdue Pharma (with respect to OxyContin), the Federal Government regulatory bodies and the 'academics' who published papers that defended these drugs as a 'good idea'.

The regulation of these drugs is not within the control of Nancy Orr or the PEI government. Even if they banned synthetic opioids on PEI, this would not quell the proliferation of these drugs on the black market. And if they are available to be had, those who want them will find a way to get them.

MENTAL HEALTH

There is an idea in Western culture that people ought to be constantly 'mentally healthy' or 'happy'. The problem is, they cannot define what this is and to try to provide for it is simply impossible.This is because if you cannot properly define a problem, you will likely fail with any solution you try to aim at it. This is largely why the majority of psychiatric drugs have failed miserably in providing any efficacy aside from (active) placebo for most alleged psychopathologies. It is likely true that our current system is still celebrating this paradigm and failing at framing the problem or 'mental health or illness' properly.

The reason we have a problem with mental health is not because people are 'sick' or 'disordered' or 'ill'. The reason people have mental problems is because they think that they have no hope for a good life. When the economy is poor and there are no opportunities for advancement, people tend to react by getting 'depressed' , anxious or otherwise. If this is true, this shows that a medical intervention a failure in framing the supposed problem. The solution to mental health issues anywhere has little to do with healthcare and a lot to do with their socio-economic climate and social policies. Countries like Switzerland have reacted to this claim in offering referendums on income equality and standard state mandated incomes for every Swiss citizen. Another example of reconceptualization is seen in Portugal, where drug dependance and addiction was reframed as not a criminal problem.

If you consider the 'failure to frame the problem' arguments, you could say that the government is responsible for aiding the ever growing problem of so-called mental illnesses and addictions. But to change or effectively remedy the issue would take a massive overhaul of how the current systems function. More drugs and more doctors will yield very little positive result and to focus on changing to a more humanist non-medical focus would be to commit political suicide. This is one reason why many governments have not accepted this reconceptualization of mental health to a preventative socio-economic model. It is now obvious that so long as it is considered cogent to think that people who are marginalized are 'sick' or 'imbalanced' and need medical interventions, no long term effective solution for these problems will be had. In fact, epidemiological studies show that despite more drugs and more psychiatric or psychological interventions, these problems have steadily gotten worse.

ADDICTIONS AND MENTAL HEALTH

When people are in pain, they will do what is necessary to remediate it. Pain can be emotional, psychological, somatic et al. Often hopelessness or poor prospects in life manifest as a form of pain and this is when people reach out for things like drugs and alcohol. Intuitively, if you can take away the reason for pain, you can then offer a solution to the catalyst for addiction and dependancy. This is not how our system is functioning at current. Instead we are in a reactionary model that shows little efficacy and almost no logic if the problem is framed in terms of a socio-economic problem instead of medical-criminal problem. This is artefact of the medicalization of mental illness and mental health legislation and another argument altogether (which most academics would argue are wrong), however this must be considered when drawing new policies to make the change to a progressive preventative model.

So to offer a good explanation as to why the government of PEI is ineffective or shows a lack of leadership on these points would be to say that (a) they haven't conceptualized or framed the problem properly, and (b) if and when they finally do come to frame it properly, they will encounter incredible political dissonance from professional organizations, the installed bureaucracy and many people at large. With respect to socio-economic policy change there is also a moral argument underlying how these problems are treated (which is an argument for another day).

Essentially, to make the necessary changes to effectively quash these problems would be considered 'radical' and cost any government the next election.

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