He was a Harvard graduate with a MBA. He had volunteered to go to Vietnam and work with the U.S. Agency for International Development. He had served under two presidents as a public-policy adviser. He owned the Denver Broncos. He was heir to one of the largest health care organizations in America.
But when a family member of Edgar Kaiser Jr. came looking for help with mental illness and drug addiction in 1985, the Vancouver, B.C., resident was at a loss for answers.
“We didn’t know what to do,” he said of his family member’s request. “It made me think others probably didn’t know where to turn either, and that’s when we decided to develop the directory so people could get help.”
It was a simple act at first: Track every center or program available in British Columbia that either treats mental illness or addiction and organize it as an easy-to-obtain directory.
The work, however, led to the creation of a nonprofit that funds controversial drug programs in Vancouver, including free needle distribution.
Now, the Canadian-based Kaiser Foundation is taking a page from San Francisco’s book. It’s attempting to fund, and raise awareness for, other controversial “harm-reduction” therapies that treat drug dependence by addressing associated mental and psychological issues that often plague users.
“The crossover of mental illness and drug addiction is real,” Kaiser said. “Mental health and addiction are health issues, not moral issues.”
Harm reduction, Kaiser said, began as a safe needle exchange. In Vancouver, where the foundation is based, a clean needle-exchange program in the Downtown East Side was implemented to prevent the spread of disease without the fear of punishment from law enforcement. But critics then and now, he said, argue that supplying needles to users only enables them.
“It’s very controversial,” Kaiser said of the safe-injection sites. “But studies show they do help.”
Doing more to change people’s mentality on drug addiction, he said, is the bigger challenge.
Kaiser said many people associate harm reduction simply with the needle program and in turn assume it supports drug users.
But much more encompasses harm reduction, he said, including addressing the psychological issues of drug abuse, along with such simple problems as housing and basic supportive services.
“Yes, we have a needle exchange, but there’s no place for them to go, no beds to take them in,” Kaiser said. “So they end up back on the street. We are trying to change that in Canada.”
Harm-reduction treatment is known as the alternative to the 12-step programs that are widely used to treat addiction and abuse. It usually coordinates individualized treatment of addiction, which sometimes includes minimal drug use, coupled with intense psychotherapy. The most well-known form of the 12-step program is Alcoholics Anonymous.
Although Kaiser said the 12-step programs can help kick drug or alcohol habits, for some the problem is deeper.
“Oftentimes, something traumatic happened in childhood and they just haven’t dealt with it,” he said. “It’s not a subject society wants to talk about.”
Kaiser is having difficulty helping harm-reduction programs become recognized as effective in Vancouver, but San Francisco already has implemented such a policy. According to the Department of Public Health, The City passed a resolution in 2000 that recognized harm reduction as the approach for treating drug users and homeless people who have substance and mental problems. Each program is tailored to the individual and the individual’s needs.
Kaiser said he has researched San Francisco’s harm-reduction program, and similar ones in New York, Hong Kong and Sydney, to strengthen Canada’s approach.
Modest in his own efforts in reducing harm and changing policy, Kaiser prefers to give credit to the men and women who work in the field every day.
“We’re not the heroes,” he said of the foundation. “It’s the people out there who do this every day for little pay and no recognition — they are the heroes.”
For some, it’s just a matter of tackling addiction slowly
Eighteen months ago, Sean Lawson had hit rock bottom. He was drinking morning, day and night.
The self-described alcoholic said he wanted to stop binging daily on Jack Daniels whiskey and Budweiser, but did not know how.
At 45 years old, Lawson attempted Alcoholics Anonymous, but the 12-step program demanded he give up all association with alcohol and other substances, which he did not see as necessary. He just wanted to put his life back together.
“I had been drinking every day for three weeks,” Lawson said. “I had this plan to go to yoga, go to work, but I failed to do all of that because I was drunk every day.”
Lawson knew he needed help. After a short Internet search in January 2008, he came across Dr. Patt Denning and the San Francisco-based Harm Reduction Therapy Center. He decided to give it a try.
Harm reduction is a client-based program that treats individual drug abuse and each associated problem, coupled with psychotherapy. It aims to curb addiction by rooting out the underlying cause, which experts say is often related to childhood trauma and mental illness.
Denning said clients will have multiple addictions to treat, but come to the clinic for one issue, such as drug use, before dealing with the others.
“Most people with severe substance abuse have had severe trauma,” Denning said. “People who want help have to arrive at it on their own. We let them do that.”
However, Lawson said he cannot stop once he starts drinking. Denning and members at the clinic do not judge him if he has a drink during treatment, which is the case in other programs.
According to Denning, clients she sees come to the harm-reduction-therapy clinic as they feel necessary. She said typically a client will stay for two years. During that time, clients choose their goals — whether they want to completely purge drug use or just do it recreationally — and also meet with psychiatrists and groups counselors to help stay on track.
The clinic operates on a $1 million budget and has 12 staff members at seven locations in San Francisco and Oakland.
Harm reduction began as a safe needle exchange in the 1980s to help prevent the spread of HIV and hepatitis C, but the association with drug use never left the term. According to the Centers for Disease Control and Prevention, the federal government will not fund programs that use the term “harm reduction.” Instead, the terms risk reduction or health promotion are more commonly used.
Alice Gleghorn of the San Francisco Department of Public Health said there is hope the stigma associated with harm reduction may change with the Obama administration.
“The term was demonized,” she said. But the Department of Public Health “has always recognized harm reduction.”
San Francisco passed a resolution in 2000 recognizing harm reduction as the public-health approach to reduce abuse and treat mental illness and drug use, Gleghorn said.
In survey of clients conducted at the Harm Reduction Therapy Center, 100 percent of people who came to the clinic with chaotic drug use did not have such problems at the end of the two years, according to Denning. Clients also said they had less anxiety and less depression, and 47 percent of people ended up abstaining from their substance of choice.
“Some never had another drug of choice,” Denning said, “and no one moved from recreational use to abuse.”
Twelve-step programs, though, say they have helped thousands of people successfully quit drugs or alcohol.
Lawson said he’s taking everything one day at a time.
“I know I’m never going to be able to have just a couple of drinks,” he said, “but that’s my responsibility, my choice.”
—Andrea Koskey
Edgar Kaiser Jr.
Age: 66
Born: Seattle
Lives: Vancouver, B.C.
Education: B.A., political science, Stanford University; MBA, international finance, Harvard University
Occupation: Chairman and CEO, Kaiser Foundation
Current involvements: Canadian Centre on Substance abuse; Scripps Foundation for Medicine & Science; Salk Institute for Biological Studies; Boys & Girls Club; Global Asset Management; World Presidents’ Organization
Former occupations: Chairman and CEO, Denver Broncos; assistant to presidents Richard Nixon and Lyndon Johnson; chairman and CEO, Bank of British Columbia; chairman and CEO, Kaiser Steel Corp.; vice president and director, Kaiser Industries Corp.
Family: Grandson of Henry J. Kaiser, founder of Kaiser Permanente; wife Sue, four children and two grandchildren
Currently reading: “The Match: The Day the Game of Golf Changed Forever” by Mark Frost; “American Caesar” by William Manchester
Watching on TV: “Boston Legal,” “Friday Night Lights,” “Jeopardy!” (“It’s like playing chess”)
Inspiration or role model: “I don’t think there is just one. I’m a huge fan of President Lyndon Johnson. His legislative record is better than early days of the New Deal.”
Biggest criticism: Safe injection sites, they’re very controversial. People think its supporting drug users. But it’s also been done in Europe; it’s clearly a good thing there.
Biggest failure: I invested — along with many others — in a french-fry company called Spud Stop, where it would be like a Coke machine and you would get fries in 60 seconds or less. They were supposed to taste most like McDonalds. The company making the machine was in Korea. We found out there were no machines. The company caved some time after I pulled out.
Favorite accomplishment as owner of Broncos: I did the trade that brought John Elway to Denver. It turned out to be a good deal.
