What we want
Community-focused.
Support low-income communities.
Services for people with addiction or severe mental illness are often disproportionately concentrated in low-income communities. Policymakers must make siting decisions fairly and ensure that these facilities do not have negative effects on surrounding communities. Shelters, detox facilities and other first-line services should not be located in the immediate vicinity of schools.
In addition to solving the immediate crisis, our mission is to enable people and communities to thrive. Part of that is preventing drug addiction and untreated mental illness in the first place. Another part is supporting people in recovery so they can continue to grow and thrive rather than relapsing.
Provide appropriate drug education in schools.
Every young person in North America must be taught what addiction looks like, that recovery is possible for everyone, and where to find help.Other cities have faced problems of homelessness, addiction, and untreated mental illness, similar to our current crisis, and solved them. The most famous examples are in Europe: Amsterdam, Lisbon, Frankfurt, Vienna, Zurich. But Calgary, Alberta is also making big strides to solve its homelessness crisis.
A Closer Look: Prevention, Intervention, Treatment, and Recovery
1. Psychiatry for all
The ultimate goal of policies on mental health and addiction must be to incentivize recovery, not enable it. Service providers should nudge clients in the right direction using a combination of carrots and sticks.
There is a place for harm reduction policies provided that they are part of a recovery-oriented continuum of care. Without this continuum of care, supervised consumption sites are not an appropriate solution to the addiction and overdose crisis.
2. Close drug markets
Local, state and federal governments must take action now to shut down the open dealing of deadly drugs on social media, on sidewalks, and in tents through a combination of social services and law enforcement.
3. Shelter first
Everyone has a right to basic, safe shelter. Governments need to build sufficient emergency shelter space to house all homeless people, and require them to use it rather than living in dangerous and unsanitary encampments. Permanent housing should be safe and it should be earned, not given away without conditions.
As our Pillars find traction in cities and programs across the country, we’re also devoting effort, expertise and resources in ways that produce more resilient, more vibrant communities.
One way to think about our policy proposals is with four major pillars: prevention, intervention, treatment, and recovery. These represent a continuum of care that can benefit everyone in a community.
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Education
Youth and young adults across North America must be properly educated on the effects of the illness of addiction, including:
• Addiction is an illness that exists within the person, not a specific drug.
• How to recognize the behaviors of addiction
• The consequences of addiction
• Where to seek treatment and recovery
Every young person in North America must be taught that recovery from addiction is possible for every person no matter who they are.
Increasing recovery capital
Recovery capital is the sum of the internal and external factors that a person can draw upon to enter and maintain their recovery should they develop the illness of addiction. Good support systems reduce the likelihood that someone will become addicted in the first place, and also help prevent relapse during recovery.on text goes here
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Drug addicts, by definition, lack control over their need to consume drugs — they cannot simply decide to stop using and basing public policies and programs on that assumption is naive and irresponsible. To quit their habits and begin to build a new life, most require some kind of intervention.
This intervention can come from family, the workplace, friends or colleagues. But many addicts have long been estranged from everyone they once knew in their pre-addiction lives, and now know only other addicts. For these people, intervention can only come from the community at large.
Intervention in the Current System
Currently, the primary way that the community intervenes in the lives of addicts is through the police and the criminal justice system. This can produce positive outcomes: countless addicts have found recovery only by being arrested and incarcerated. But there are far better ways to steer addicts into recovery than jail.
Another emerging means of community intervention in the lives of addicts is through recovery-oriented homeless outreach workers. Constraints to how and what social workers can offer addicts reduce potential outcomes.
Compassionate Intervention Process
We propose a form of compassionate intervention that is not a criminal process, but rather a compassionate public safety and healthcare response to help people struggling with addiction to pursue recovery.
Many people living with serious mental illness or the illness of addiction have lost the capacity to recognize they are ill and seek treatment. They are no longer in control of their own behavior and deserve our compassionate intervention to support them in their long-term recovery.
The Process
The police should have the authority to apprehend people who are a danger to themselves or the community, possibly with a social worker or EMS worker accompanying.
Police would then take the individual to an administrative commission for the dissuasion of drug addiction – not a criminal court.
The commission would assess the individual for their addiction, and recommend treatment options for their addiction.
Should an individual refuse a referral for treatment and they remain a danger to themselves or others in the community they would be sent before a judge to determine whether the individual should be mandated treatment for their addiction.
Community Support
When someone falls ill with addiction or serious mental illness, families and workplaces are both most immediately affected and most able to intervene. Intervention must also include education for families and workplaces on how to intervene and assertively support individuals to pursue recovery.
Infrastructure
This model requires a critical mass of treatment capacity that is affordable and accessible to any citizen, as well as the cooperation of the healthcare system and the criminal justice system.
We don’t have to choose between compassionate treatment and healthy communities.
This system balances the welfare and liberty of the drug user on one hand, and the rights of the public to safety and order on the other. It also uses the power of the state as a last resort to compel people who have lost the capacity to help themselves toward a life of independence, health and dignity.
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Addiction is a chronic illness, and with the appropriate treatment, recovery can and should be expected. The goal of addiction treatment is to initiate recovery from addiction and teach people how to maintain their recovery over the long-term. Treatment must be affordable, accessible, and ideally available on-demand.
People with addiction need a range of treatment options:
• inpatient residential treatment
• transitional “recovery housing”
• long-term therapeutic communities
• medication-based opioid addiction treatments such as Suboxone and Sublocade
• outpatient group therapy
• individual counseling
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Supporting individuals in their long-term recovery from addiction is the final piece of the puzzle. Where treatment is the brief intervention that is used to initiate recovery in people with addiction, supporting long-term recovery after treatment is just as important.
To effectively support recovery over the long-term, policy and funding across North America must focus on improving the recovery capital of individuals and their communities.
Recovery capital is the sum of the internal and external resources that a person can draw upon to enter and maintain recovery. This includes ensuring people have their basic needs met in recovery through recovery housing, it includes supporting people in recovery to seek employment and regain independence, it includes creating communities where people are supported in the improvement of their relationships with other people and their spiritual life.
Control
Society should empower everyone to achieve their full potential—addiction recovery and a life lived with purpose is our ultimate goal. Discouraging non-medical substance use of all kinds, including legalized drugs like alcohol, tobacco and marijuana, is part of the picture.
Medical vs. Non-Medical Use
The authority to define accepted medical use of drugs lies with neutral, scientific institutions and authorities such as the Food and Drug Administration.
In the case of marijuana, corporate interests and lobby groups promoted the idea of medical use, with very little neutral scientific evidence. Corporate or political attempts should not define “drugs as medicine” or influence these scientific institutions.
Drug Use by Young People
If someone does not misuse a drug before age 21, they are unlikely ever to do so. This includes legalized drugs such as alcohol, tobacco and marijuana. Policies should include rigorous youth education on the harms of addiction, and should aim to make drugs less accessible to young people.
Policy Examples
Federal, state, and local policies should discourage or seek to reduce the volume of the non-medical use of drugs available, including alcohol, tobacco, marijuana, and so forth. Some effective policies to reduce use of legalized drugs include:
• Increases in taxes
• Restrictions on advertising
• Potency restrictions
Culture
Discouragement of drugs should come from multiple sectors in society, including laws (e.g. keeping drugs illegal), community norms, corporate standards, and public awareness campaigns. Non-medical users, particularly those in addiction, should always be given the opportunity to achieve a life of recovery.