Pubdate: Fri, 05 Jan 2018
Source: Vancouver Sun (CN BC)
Copyright: 2018 Postmedia Network Inc.
Author: Trina Larsen Soles
Page: A15


Adverse childhood experiences linked to drug abuse, says TrinaLarsen

The opioid epidemic is the biggest public health crisis to hit B.C. in
decades. Upwards of four people a day are dying of overdoses, usually
due to fentanyl poisoning of the street drug supply.

To date the B.C. government has committed $322 million to address the
crisis, including opening more supervised consumption sites, providing
naloxone kits, urging people not to use alone, and trying to stop
tainted drugs from coming into B.C.

Another potential response, in addition, could deepen our public
understanding and shift our approach to a more compassionate and
effective outcome: recognizing and addressing the underlying role of
adverse childhood experiences - ACEs - and how they make individuals
more vulnerable to substance use.

The connection of ACEs to future chronic health conditions, social and
behavioural problems, mental illness, addictions and early death has
been known since the late 1990s. Called one of the greatest public
health findings of all time, ACEs research studies now number in the
hundreds worldwide.

In general, ACEs are identified with questions about exposure to
physical, sexual or emotional abuse, parental addiction, divorce,
domestic violence, and other forms of trauma or neglect. One tool
generates a score on a 10-point scale. The higher the number of ACEs,
the greater the potential relationship to future social, behavioural
and health problems, such as alcoholism and substance misuse, suicide
and chronic disease.

Researchers are investigating the neurobiological mechanisms that are
involved, such as the impact of toxic stress on the developing brain.
Still others have been studying what can be done to mitigate the effects.

Despite two decades of powerful research, however, the concepts have
been slow to translate into public understanding as well as into
policy and practice. Too often, those with drug addiction, like those
currently overdosing and dying, are subjected to public condemnation,
humiliation, further neglect and ostracism, and further traumatization
- - often by the very people who are meant to help them.

There is a better way.

Last November more than 600 people from B.C., Alberta, Saskatchewan, 
Ontario and the U.S. gathered in Vancouver to explore and share 
approaches to acknowledging, mitigating and preventing ACEs. The ACEs 
Summit: B.C. and Beyond, was a two-day conference that brought together 
physicians, mental health experts, educators, academic researchers, 
First Nations organizations, criminal justice representatives, community 
agencies, health authorities, provincial government policy-makers and 
politicians, as well as youth and families impacted by ACEs.

We heard from Judy Darcy, the provincial minister for mental health
and addictions, who stressed that addiction is not a moral failure,
but a health issue. She emphasized the importance of treating those
with mental health and substance use issues with the same dignity and
compassion that we treat those with physical health issues.

The summit was funded and organized by the shared care committee, a
partnership of Doctors of B.C. and the Ministry of Health, and
featured multiple presentations and panels to discuss and strategize
how to embed ACEs awareness and response into all aspects of society,
such as schools, communities, family doctors' offices, maternity care,
mental health and addictions treatment and the criminal justice system.

A five-member panel on ACEs and the opioid crisis brought into stark
light how our current approach actually contributes to higher death
rates by isolating individuals who hide their addiction out of shame
and use alone.

Panelist Calgary Police Chief Roger Chaffin stated that we can't
arrest our way out of the problem, and that the focus has to be on
people before they become addicted.

Linda Lupini of B.C. Emergency Services reiterated what many of us may
not realize: that individuals who are dealing with emotional and
physical pain through opioid addiction, were doing all this under the
radar, and the reason we are talking about it now is because their
supply is poisoned. She stated that this has told us there are many,
many more people than we ever realized who are struggling with this

Although the opioid crisis is a difficult one, the ACEs Summit centred
on a message of hope. By focusing on understanding ACEs and how they
contribute to addiction and other serious health conditions, we can
enable more compassionate treatment and more effective prevention.

Together we can help heal those with ACEs already in their life story,
and limit the creation of new ACEs in future generations.

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Dr. Trina Larsen Soles is president of Doctors of B.C.
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