Policy debate on substance use is a lot like groundhog day

While Canadians are dying in record numbers from substance use and substance use disorders, instead of embracing successes of the past, many of Canada’s public- and private-sector leaders appear to be starting over to find solutions that already exist. For almost a decade, beginning in 2007, I had the privilege of serving the board of the Mental Health Commission. From its inception, the commission, in collaboration with Canada’s pioneers in mental health advocacy, began a challenging and crucial journey: to transform Canada’s mental health care system for the one in five Canadians woefully neglected by our mental health system. That the commission’s inaugural chair, Mike Kirby, declared mental illness the "orphan" of health care was no overstatement. In close collaboration with Canadians who have been or are affected by these issues, along with their family members, health care practitioners, academics, and the public and private sector, improvements have been made to the level of care offered to Canadians living with mental illness. And while the transformation is far from complete—Canada spends the least on mental health care treatment and services of the world’s developed countries—many feel hopeful that mental wellness for all is no longer an impossible dream. Unfortunately, the same is not true for Canadians living with substance use disorder. In the months following my leave of the commission, news of a family member living with substance use disorder led me to active grassroots involvement. More recently, I have turned my attention to nationally focused advocacy aimed at tackling an all too familiar refrain: insidious stigma, shameful levels of care and treatment, and ignorance born of decades of bigotry and discrimination, which leave a growing segment of Canada’s population orphaned from the treatment and supports that saves lives. And while many well-intentioned public officials and advocacy organizations actively debate how best to respond to the current crisis, my journey with the commission leaves me wrestling with the trope: this must be groundhog day. Like the shameful history of care once offered to those living with mental illnesses, many Canadians living with substance use disorder die before care and treatment can be obtained. An avoidable case of history, regrettably, repeating itself. Many of the same barriers to care when living with a mental illness, beginning with bigotry and discrimination, explain why a person may choose to hide their illness rather than seek treatment. Yet the solutions to tackling the stigma, to improving care, and to supporting those struggling with a health disorder have, for the better part of a decade, been exhaustively debated by Canada’s foremost public and private leaders. The solutions to addressing the rising rates of substance use disorder and death by overdose are near-identical to those developed along the journey to improved mental health care in Canada. In a recent report by the Public Health Agency of Canada, the gravity of the substance use crisis was made evident: “Across the country, is having devastating effects on the health and lives of many Canadians, their families and their communities.” In Canada, between January 2016 and June 2018, more than 9,000 people lost their lives related to opioids. It is a number that is staggering and impossible to ignore. Canada needs swift action and less talk to effectively address this current crisis. Many agree that the catalyst that sparked the transformation of Canada’s mental health system was the Senate committee 2006 report, Out of the Shadows at Last: Transforming Mental Health, Mental Illness and Addiction Services in Canada. The report drew national attention to a health-equity issue long ignored. It’s regrettable the commission began its journey with a mandate to only tackle the recommendations pertinent to mental health. Had the commission been given a mandate to address both mental illness and addictions services in Canada, many of the lives lost to problematic substance use would have been spared. Canadians must fight the inclination to consult for the sake of consultation, but instead embrace what has already been accomplished and push ambitiously forward. There is no good reason to reinvent the wheel. Men and women are dying while we repeat the past. Patrick Dion is the past vice-chair of the board of the Mental Health Commission of Canada. The Hill Times

Policy debate on substance use is a lot like groundhog day

Many Canadians living with substance use disorder die before care and treatment can be obtained. It's an avoidable case of history, regrettably, repeating itself, writes Patrick Dion, formerly of the Mental Health Commission of Canada.

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Policy debate on substance use is a lot like groundhog day

Many Canadians living with substance use disorder die before care and treatment can be obtained. It's an avoidable case of history, regrettably, repeating itself, writes Patrick Dion, formerly of the Mental Health Commission of Canada.

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