Justice costs of stimulant use in Downtown Eastside not reduced by current treatment options
Tamara Condo in Vancouver, B.C., September 28, 2017. (Arlen Redekop/PNG)
A study of nearly 1,600 drug users on the Downtown Eastside found that people who use multiple stimulants daily cost the justice system thousands of dollars a month, and that currently available drug treatment programs do not reduce the costs of crime.
Researchers sorted drug users into eight categories based on whether or not they used stimulants daily — typically methamphetamine, cocaine and crack cocaine — and by which stimulants they used, alone or in combination. Participants self-reported their drug use and contact with the justice system every six months, in 5,299 interviews.
The estimated crime costs associated with the daily use of multiple stimulants by the neighbourhood’s residents are about $8,900 per user per month, the four-year study found. Those costs include police time, court appearances, incarceration and parole, and victims’ costs.
“These are really big numbers,” said study co-author Ben Enns, a health economist at the B.C. Centre for Excellence in HIV/AIDS. “We are trying to make an economic case for more research because there aren’t any pharmacological treatments available for stimulant users.”
By contrast, opioid users have multiple drug-replacement therapies available to them.
More than 19,000 opioid users are enrolled in drug-replacement programs that prescribe either methadone and suboxone in B.C.
About 110 addicts in Vancouver get prescription heroin and 25 receive hydromorphone at the Crosstown Clinic through a research program called the North American Opiate Medication Initiative, or NAOMI.
Treatment interventions for opioid users reduce lifetime crime costs by about 75 per cent, according to previous research.
“The research around treatment for stimulant use disorders is really sparse, but the rate of stimulant use is at or near that of opioid use,” said Enns.
A treatment as effective as those available to opioid users could save around $7,000 a month for daily users of multiple stimulants.
People addicted to stimulants are frustrated by their options.
“People will tell you that it’s better to try to quit on your own and use your willpower,” said Tamara Condo, a volunteer at the Vancouver Area Network of Drug Users (VANDU). “A lot of people I know have gone through (methamphetamine) withdrawal and they get sick. It’s really hard.”
Condo, who uses heroin and methamphetamine, has tried to quit four times in the past two years, but her best success came when she was away from the Downtown Eastside.
“In 2009, I was in a recovery house for seven months. I loved it and I miss it,” she said. “Being on the downtown streets does not help if you want to quit.”
The study, which involved researchers from Simon Fraser University and UBC, did not account for the health care costs associated with stimulant use, but they are likely substantial.
Providence Healthcare estimates the justice and healthcare costs associated with a single opioid addict at $48,000 per year. The cost of Crosstown Clinic’s prescribed heroin program is about $27,000 per patient annually.
B.C. Health authorities operate 1,457 treatment beds for substance abusers, including 333 for sobering and withdrawal and 330 intensive residential recovery beds, according to the newly formed ministry of mental health and addictions. Another 636 beds are for short- and long-term residential supportive recovery.
Meanwhile, the Vancouver Business Improvement Association Partnership — representing thousands of city businesses — is calling on the provincial government to support an immediate expansion of opioid treatment programs, including injectable heroin.
Business owners and their employees must deal with public urination, defecation, dirty needles and even corpses as the toll of the opioid crisis rises, said Landon Hoyt, executive-director of the Hastings Crossing Business Improvement Association.
“These treatment options are radically underfunded, yet have incredible potential to curb the overdose crisis, improve our addictions system of care, and save taxpayer money,” he said.