Is There a Compassionate Approach to Addiction, Prostitution and Poverty? Dr. Mark Tyndall | MC4 L5

Mark Tyndall, MD, ScD, FRCPC, British Columbia Center for Excellence in HIV/AIDS, Department of Medicine, University of British Columbia

TEMPLETON SYMPOSIUM - Is There a Compassionate Approach to Addiction, Prostitution and Poverty?

BALLROOM 2 3:30 p.m. – 5:00 p.m

The Downtown Eastside of Vancouver is the poorest community in Canada and has become synonymous with drug addicts, prostitutes, violence and disease. For decades the zeal to “clean up” the area has dominated civic politics and is a favorite location for opportunistic journalism from both national and international media. The 16,000 residents of this community have been squeezed into a 10-block area of the city with most living in squalid single occupancy hotel rooms. Women are especially impacted by this harsh social environment as many are street-entrenched, drug-dependant, exposed to dangerous sexual liaisons, and fail to meet even the most basic needs of food and shelter. The acute and long-term adverse health consequences associated with illicit drug use and poverty has been severely impacted by the explosive epidemic of HIV infection in the early 1990’s, creating a full-blown public health crisis. Within this scenario the implementation of standard health care interventions have been ineffective. Despite some good intentions and large amounts of both public and private expenditures aimed at improving the health and general living conditions within this community, the outcomes have been modest at best. The main thrust of existing interventions continues to be based on punishing the victims; the message is consistent – you are a bad person, you make stupid decisions, you are a junkie, you are a thief, you are worthless. What role does compassion play? Can compassion help to break the cycle of drug addiction, prostitution and disease for people in this community and others like it? Compassion is the essential component for anyone who successfully emerges from this environment. From a programmatic standpoint, the compassionate approach to addiction is called “harm-reduction.” This movement acknowledges that people are addicted to drugs and in all likelihood will not be stopping in the near future. It is not good enough to continually punish them for their addiction and associated behaviors. If people are going to inject drugs anyway, why would society want them to inject inside a filthy dumpster, use a dirty needle, or engage in criminal behavior to support their drug habit? Harm reduction programs need to be supported and expanded. It is the practical application of compassion that can make a difference in the lives of people trapped in addiction and poverty.

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