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Time for a Fresh Start on BC’s Addictions Recovery Strategy

Dependence on AA-style programs needs to be replaced with easy access to evidence-based options.

By Ian Bushfield 1 Aug 2018 | TheTyee.ca

Ian Bushfield is executive director of the BC Humanist Association.

In 2016, CBC journalists Yvette Brend and Majula Dufresne phoned every drug rehab facility in British Columbia.

After speaking to over 150 different facilities, they found little in the way of standards of care. Most operated using a faith-based Alcoholics Anonymous or 12-step program and many dismissed proven harm reduction approaches as “all nonsense.”

The previous year, Byron Wood lost his job as a nurse after refusing to attend AA. Wood is an atheist and wanted to attend a secular recovery program after admitting his substance use issues to his employer. His treatment plan required him to attend a 12-step residential rehab facility and following up with AA, which requires belief in God or a “higher power.”

Ultimately, Wood filed a complaint with the BC Human Rights Tribunal, which should be heard this fall.

While many people have stopped drinking or taking drugs after attending Alcoholics Anonymous or other 12-step programs, there is no good scientific evidence that these programs work.

Further, U.S. courts have repeatedly ruled that AA’s program is religious and that the government cannot require someone to attend without violating their religious freedom.

Canada doesn’t have the same explicit constitutional separation of church and state that the U.S. has. However, the Supreme Court of Canada has expressed in no uncertain terms that our governments have “a duty of religious neutrality.” So why do faith-based treatments permeate so much of our approach to treating addictions?

Much of it is historic. AA developed in the 1930s before a modern understanding of addiction developed. At the time, addictions were viewed as a moral failing and a penance model developed based on Protestant teachings.

Compare the approach we use for people trying to quit drinking with those who try to quit smoking. The latter techniques were developed much later, after we’d realized the health risks of smoking, and relied on replacements like the patch or other harm reduction techniques.

Luckily, there are other models to help people deal with substance use issues that are both secular and apply the best available evidence. These programs, like SMART Recovery, take a harm reduction approach and use cognitive behavioural therapy. Other programs, like LifeRing, replicate the group support model of AA but dispense with the dogma in favour of facilitated discussions.

British Columbia, having been at the front of the overdose crisis for years, has been the most welcoming to these types of approaches in Canada, but they are still foreign to many doctors and other health care professionals.

Nevertheless, with long wait times at overcrowded facilities, British Columbians seeking treatment might find a faith-based program is the only option. Others aren’t even given a choice, as employers and courts in B.C. are still mandating that people attend AA, and it’s often the only option for people in correctional facilities.

There’s a chance to change things, however.

The ministry of mental health and addictions, created last year by the new Government of BC, has started a consultation on a draft mental health and addictions strategy. This strategy will underpin the government’s approach to tackling these issues for years to come.

The BC Humanist Association has started a petition calling on the government to put secular recovery options first. Every British Columbian has the opportunity to contribute their thoughts on how the strategy should take shape.

Doctors, the health care system, employers and our judicial system should prioritize access to secular and evidence-based treatment programs. To do otherwise is to continue losing lives and wasting limited resources.  [Tyee]

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