Saturday, March 28, 2009

BCMA’s progressive addiction policy

The BCMA has done something good. It has called for accessible and publicly funded treatment for substance-use disorders and compulsive gambling. The inadequacy of treatment resources for people with addictive disorders is well known to patients and their families, and to physicians of British Columbia. The stigmatization of these disorders, however, robs patients and families of a public voice. Alcoholics Anonymous has its name for a reason. Physicians must be advocates for such people.

The BCMA published a policy paper which has received significant media attention, including a headline story in the Vancouver Sun. The summary of recommendations includes a call for the ministry of health to “recognize addiction as a chronic, treatable disease.” Furthermore, the BCMA asks the province to “ensure that access to addiction care is accessible without financial and other barriers throughout BC; this includes the elimination of per diem fees, minimization of language barriers, and access to inpatient addiction care.” The request goes further: “Create and fund” 840 new treatment beds.

Organized medicine in Canada seems ready to turn surgical care and imaging services over to for-profit enterprises. It is refreshing for a provincial medical organization to advocate for public delivery and funding of treatment for chronic diseases that devastate individuals and communities, and that place a massive burden on acute-care hospitals.

The deliberate inclusion of gambling as an addictive disorder that deserves publicly funded treatment is noteworthy. Although the policy paper does not point out government’s conflict of interest as the regulator and beneficiary of “gaming” revenues, the authors must recognize government's responsibility to those who become addicted. Lotteries in particular are a regressive, albeit voluntary tax that many North American jurisdictions rely upon. Perhaps it is too much to ask that the BCMA call for the elimination of government-sponsored gambling.

Randall F. White, MD

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