Michael Krausz – Treatment of Addiction and Concurrent Disorders: Between Prohibition and Stigma (Federico)

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According to Dr. Michael Krausz, the LEEF Leadership Chair in Addiction Research, chronic substance abuse and mental illness are of critical concern and pose significant challenges, especially when they are co-occurring. Dr. Krausz recently brought his international expertise in concurrent disorders – the dual diagnosis of mental illness and drug addiction – to the University of British Columbia to address the crisis in Vancouver’s Downtown Eastside where addiction, psychiatric illness and homelessness are rampant. Hailed as the poorest postal code in Canada, the Downtown Eastside is a microcosm of social problems where overdose and suicide are the leading causes of death.

At the “Neuroethics of Addiction” conference Dr. Krausz’s message was clear – treatment availability and access to those is need is seriously lacking in Vancouver. Dr. Krausz stated that he views the current situation as ethically problematic. For instance, he stressed that people with addiction and mental health issues have the highest unmet need for treatment but are often excluded from medical care, have increased rates of mortality and are amongst the most stigmatized and socially marginalized of groups. They suffer from many health-related burdens including HIV/AIDS, Hepatitis C, suicide, addiction-related cancers and homelessness. Nevertheless, a general lack of  treatment and support is available. It it Dr. Krausz’s hope that the BC Centre for Excellence in HIV/AIDS will serve as a model for the creation of a similar Centre for Excellence, to provide focused resources and structures to facilitate state of the art addiction and mental health research in Canada.

Dr. Krausz described the current situation in Vancouver’s Downtown Eastside as being in “crisis mode” and lamented that emergency care is an insufficient reaction to the increasing needs of the community. He stated that part of the issue is the misconception that addiction is a moral issue – bad people making poor choices and until the public at large realizes that addiction is their problem too, no real change will take place.