Today, concerned people across Alberta are demanding transparency around #addiction treatment. Many of these people have undergone treatment or had loved ones who did.
Here is a story I've never told that helped inform my views on treatment. 🧵 1/12
#ableg #abpoli
Here is a story I've never told that helped inform my views on treatment. 🧵 1/12
#ableg #abpoli
https://twitter.com/_EachAndEvery/status/1534225433297707009
The first person I ever knew to die of a drug overdose (i.e. known substance, excessive dose) had attended an expensive, faraway addiction treatment facility just a couple months before. I'll call them Terry. 2/12
When the grieving family tried to piece together what had caused Terry's death - Terry had been treated for their addiction, after all - the family was told by the treatment facility, on no evidence, that Terry had likely succumbed to the "kindling effect". 3/12
Kindling explains that acute withdrawal hits harder with each successive attempt to quit.
Wikipedia: "Each withdrawal leads to more severe withdrawal symptoms than in previous episodes." 4/12
Wikipedia: "Each withdrawal leads to more severe withdrawal symptoms than in previous episodes." 4/12
So kindling clearly has little relevance to how Terry died from re-exposure to opioids, considering they'd already gone through withdrawal and achieved abstinence.
However, there is a more logical explanation we should explore. 5/12
However, there is a more logical explanation we should explore. 5/12
When you use opioids regularly, you build tolerance and require more to achieve a similar outcome.
We saw this with fentanyl - nowadays, this is the strength people have adapted to (because of prohibition), despite its extreme potency relative to earlier opioids. 6/12
We saw this with fentanyl - nowadays, this is the strength people have adapted to (because of prohibition), despite its extreme potency relative to earlier opioids. 6/12
If you resume using opioids after going abstinent, i.e. you 'relapse', then your opioid receptors are more sensitive than they were when you were using more regularly, and you are more prone to overdosing. 7/12
The treatment centre could have explained the danger of managing abstinence after years of steady use.
Instead, they chose to gaslight. 8/12
Instead, they chose to gaslight. 8/12
In Alberta, despite the emphasis on abstinence, we don't know how many people die following a relapse.
We don't know how many people don't get into treatment when they want to.
We don't know how many die waiting.
We don't how many die participating. 9/12
We don't know how many people don't get into treatment when they want to.
We don't know how many die waiting.
We don't how many die participating. 9/12
We don't know the qualifications of the staff in addiction treatment.
We don't know how they address cultural, economic or community needs of Indigenous peoples or any racialized group.
We don't know how they manage intake, conditions of participation or follow-up. 10/12
We don't know how they address cultural, economic or community needs of Indigenous peoples or any racialized group.
We don't know how they manage intake, conditions of participation or follow-up. 10/12
In short, we have not set measures of success for addiction treatment in this province other than how many people enter these programs, yet we're throwing hundreds of millions of dollars into abstinence while continuing to stigmatize drug use. 11/12
Terry didn't die alone from kindling.
It was stigma, and it was shame.
And if we're going to get out of this crisis, we need to listen to the survivors, without stigma and without shame, and start asking some questions of our own. 12/12
It was stigma, and it was shame.
And if we're going to get out of this crisis, we need to listen to the survivors, without stigma and without shame, and start asking some questions of our own. 12/12
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