While due to the opioid crisis, the much-needed focus in recent years has been put on harm reduction, acute treatment and reducing stigma for those with addictions, experts say an equal emphasis needs to be put on addressing the root causes of substance abuse.
Dr. Vijay Seethapathy, a psychiatrist who specializes in addiction and concurrent disorders, stresses there is often trauma or a mental health issue behind addiction.
For those people to get and stay well, those issues have to be addressed, he said.
"Trying to understand the person as a whole... is key," he said. "Going deeper into why this has all started."
Almost 52 per cent of clients with substance addictions have mental health issues, Seethapathy said. And about 50 per cent of those with mental health issues suffer from substance use issues.
For example, many clients in his field who have alcohol addictions have anxiety-related issues.
"If you don't address this as a whole, and you start just addressing the alcohol alone, then you are missing out on the core problem," he said.
Experiences during a person's formative years and exposure to trauma can predispose someone to addiction, he added.
"When a client has post‐traumatic stress disorder, the most common symptom you see is anxiety, hypervigilance — the person is not themselves — and then they lose functioning in multiple areas of their lives," he said.
PTSD is one of the highest mental health issues that is linked to substance addiction.
"We need to look at what needs are being missed and how early we need to address this," Seethapathy said. "Early detection in terms of in school, in youth, in early adulthood... We talk a lot about the aftermath of overdose and how to connect them with services — which is good and crucial and essential... — but going back upstream and going into the core problem underneath."
What the research has shown is that when you treat just one problem, then the prognosis — the effectiveness of the treatment — is not as positive, he said.
Terri-Lee Seeley, a social worker with BC Mental Health and Substance Use Services agrees, adding that for women, in particular, significant trauma, including sexual trauma, can often lead to serious substance use.
"What we know is that if a child has been sexually, emotionally, psychologically, physically harmed ... folks, and especially women are four times more likely to become involved in substance use. And that [trauma] also affects mental health concerns like depression and anxiety."
Unresolved trauma stays with people and impacts relationships, seeping into other aspects of life, she said.
To cope with unresolved psychological pain, people can turn to substances.
Seeley stresses that with the treatment of root causes of addiction, there is hope.
In her experience in working with women who have experienced trauma and struggles with substance use and mental health, Seeley said she marvels at the resiliency and the hope that they bring to recovery.
"I would like family and individuals to receive that message of hope that there are resources, there are treatment facilities and resources in your community that can assist you with the path of recovery that you choose."
Education is key for families, professionals and employers so that the addiction or bothersome substance use is seen in a broader context as possibly a way to cope with trauma, she added.
To access Mental Health and Substance Use services in Squamish call (604) 815-3008 - phone lines open Monday to Friday from 8:30 a.m. to 4:30 p.m.
Leaders weigh in
"People struggling with addiction deserve to be treated with the same dignity, respect and quality of care as people living with any other health condition," said Judy Darcy, Minister of Mental Health and Addictions, in a statement on International Overdose Awareness Day, Aug. 31.
"The greatest inroads we are making are a result of working together with all partners to increase life-saving supports throughout the province. The BC Centre for Disease Control estimates that 4,700 deaths have been averted by actions, including scaled-up distribution of naloxone, more overdose prevention sites and better access to medication-assisted treatment, known as opioid agonist treatment."
BC Liberal opposition Mental Health and Addictions Critic Jane Thornthwaite said while harm reduction approaches like overdose prevention sites and greater distribution of naloxone kits are saving lives, "they are not enough to break the cycle of addiction. In order to prevent overdoses and enact real change, we must address the roots of addiction, such as mental health issues, trauma, and abuse."
"I have long advocated for a full continuum of care to stop the overdose crisis in British Columbia. This starts with prevention in schools, expansion and greater accessibility of detox and treatment, harm reduction to keep people alive, comprehensive mental health support and publicly-funded recovery options, including abstinence-based care," she said in a news release on Aug. 31.
"I once again plead with the current government to implement the Safe Care Act. This legislation would ensure youth can be stabilized and treated for their addictions before they are discharged, and parents can be kept informed of their child's medical condition. Overcoming the overdose crisis will take much more than a one-size-fits-all approach. Only when a continuum of care is established can we hope to see a substantial difference to a crisis that continues to claim lives every day."