The real problem behind substance abuse

I applaud health officer Dr. Richard Stanwick’s forward thinking in addressing an emergent opioid-overdose situation that has gripped British Columbia.  I agree there is an immediate need to take pressure off the system and to prevent further deaths from occurring. Opening a safe consumption site might be a large piece of the puzzle, but it is only one piece. It addresses the tragic outcome of a big problem, but it won’t eradicate the problem itself.

The emotional and monetary costs attributed to responding to these overdoses, many of which are fatal, is staggering. First and foremost are the family and friends left behind or who continue to pray their loved one will find a better, healthier life. In addition, the emotional cost to those responding to overdoses is horrendous.

As Stanwick stated in a Times Colonist article (“Drug deaths prompt urgent warning,” Nov. 24, 2016) those responding to overdoses often have no more training than basic first aid and basic CPR. The unintended consequences and ripple effect is agonizing and costly.  British Columbians are dying from overdoses. So yes, let’s stop these senseless fatalities, but let’s also prevent people from spiralling down to this point in the first place. If we stop at putting one piece of the puzzle in place, the puzzle is not solved.

While we aim to respond to this provincial emergency, let’s back things up and look at how people are getting onto this road to hell in the first place. In Canada, the numbers are escalating for mental-health issues, substance use and addictions, and homelessness.

One factor that is overlooked, yet is a direct link to these life-altering issues, is brain injury.

Brain injury is the orphan in our health-care system. Nobody wants it and everyone assumes someone else is taking care of it. A person living with a brain injury will not necessarily have access to mental-health or substance-use and addiction supports. Often, they are told to “deal with the brain injury first.”

If statistics turn heads and lead us to action, here are some profound ones:

• The risk of substance use and/or addiction following a brain injury increases by 200 per cent.

• Brain-injury survivors struggle with mental-health issues such as anxiety, depression and insomnia. The risk of suicide following a severe brain injury increases by 400 per cent.

• 80 per cent of those incarcerated have suffered a brain injury, and more than 60 per cent of these injuries occurred when they were children, often from abuse.

• 53 per cent of the homeless have suffered a brain injury, and nearly 70 per cent of this group became homeless after their first brain injury.

• About 1.5 million Canadians live with a brain injury. This number surpasses those with breast cancer, HIV/AIDS, spinal-cord injury and multiple sclerosis combined.

In some areas, a person with a brain injury can face a three-year wait for services. That’s ridiculous. We would never tolerate a cancer patient being told they will wait years for services or treatment, and when they do, it will be short-term support only.  “Once it’s done, it’s done. You are on your own after treatment is finished.” So why is this happening to survivors of brain injury?

The pressure on our health-care system is extraordinary. Costs are skyrocketing. So before panic sets in and people assume I am proposing we spend more money, we won’t be.  We are already spending the money on acute care, emergency services, policing and the prisons. If we address all the issues together (mental health, substance use/addiction, brain injury) we can reduce the burden to taxpayers. We pay now for appropriate supports, or we pay later — and paying later is a much bigger cost to our society.

Safe consumption sites will prevent deaths; however, it’s crucial the gaps in services and supports are addressed as well. This means we must address mental health, addictions, and brain injury together. If not, we will never truly eradicate the problem.

In conclusion, my plea is for Premier John Horgan, Health Minister Adrian Dix, and Mental Health and Addictions Minister Judy Darcy to rename the new ministry to Ministry of Mental Health, Addiction, and Brain Injury and to ensure the mandate will address the gaps in services and supports for those living with the outcome of an acquired brain injury.

Janelle Breese Biagioni is the founder of the Constable Gerald Breese Centre for Traumatic Life Losses and has dedicated her career to supporting survivors and families living with a brain injury.

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