SEARCH

SEARCH BY CITATION

Keywords:

  • Addiction;
  • Canada;
  • centres;
  • ethics;
  • policy;
  • research

ABSTRACT

  1. Top of page
  2. ABSTRACT
  3. INTRODUCTION
  4. EVOLUTION OF THE CENTRE
  5. PRESENT CORE OPERATION
  6. DISSEMINATION, KNOWLEDGE EXCHANGE AND STAFF DEVELOPMENT
  7. REFLECTIONS ON THE OVERALL EXPERIENCE OF WORKING AT CARBC
  8. Declaration of interest
  9. References

The Centre for Addictions Research of British Columbia (CARBC) was established as a multi-campus and multi-disciplinary research centre administered by the University of Victoria (UVic) in late 2003. Its core funding is provided from interest payments on an endowment of CAD$10.55 million. It is supported by a commitment to seven faculty appointments in various departments at UVic. The Centre has two offices, an administration and research office in Victoria and a knowledge exchange unit in Vancouver. The two offices are collaborating on the implementation of CARBC's first 5-year plan which seeks to build capacity in British Columbia for integrated multi-disciplinary research and knowledge exchange in the areas substance use, addictions and harm reduction. Present challenges include losses to the endowment caused by the 2008/2009 economic crisis and difficulties negotiating faculty positions with the university administration. Despite these hurdles, to date each year has seen increased capacity for the Centre in terms of affiliated scientists, funding and staffing as well as output in terms of published reports, electronic resources and impacts on policy and practice. Areas of special research interest include: drug testing in the work-place, epidemiological monitoring, substance use and injury, pricing and taxation policies, privatization of liquor monopolies, polysubstance use, health determinants of indigenous peoples, street-involved youth and other vulnerable populations at risk of substance use problems. Further information about the Centre and its activities can be found on http://www.carbc.ca.

Solutions and strategies for dealing with the problems of substance use are often controversial and can be the topic of heated public debate. . . . there is a strong case for an independent centre to provide expert commentary on the extent and nature of problems, identify evidence-based solutions, and . . . evaluate harm reduction strategies so as to better inform . . . all involved in policy, prevention and treatment systems (A framework for addictions research and knowledge exchange in British Columbia, CARBC Strategic Plan for 2006–10 [1]).

INTRODUCTION

  1. Top of page
  2. ABSTRACT
  3. INTRODUCTION
  4. EVOLUTION OF THE CENTRE
  5. PRESENT CORE OPERATION
  6. DISSEMINATION, KNOWLEDGE EXCHANGE AND STAFF DEVELOPMENT
  7. REFLECTIONS ON THE OVERALL EXPERIENCE OF WORKING AT CARBC
  8. Declaration of interest
  9. References

The Centre for Addictions Research of British Columbia (BC) had an extraordinary beginning, almost died at birth, evidenced rapid early growth and now faces an uncertain future. The apparently secure core funding provided by interest paid on an endowment of CAD$10.55 million to the University of Victoria (UVic) in 2003 from the BC Addiction Foundation is, at the time of writing, technically ‘underwater’. This means that no funds are available for the present fiscal year (1 April 2009–31 March 2010), a situation which will continue until the financial markets recover. None the less, we are confident that what this paper describes is just the first chapter in a long story of collaboration and joint research output and policy change. We will attempt to outline our early history and reflect upon how far we have begun to realize our aspirations. The structure and subheadings used follow the brief provided by Addiction.

More details can be accessed on our website (http://www.carbc.ca), which documents the origins of the Centre and activities.

EVOLUTION OF THE CENTRE

  1. Top of page
  2. ABSTRACT
  3. INTRODUCTION
  4. EVOLUTION OF THE CENTRE
  5. PRESENT CORE OPERATION
  6. DISSEMINATION, KNOWLEDGE EXCHANGE AND STAFF DEVELOPMENT
  7. REFLECTIONS ON THE OVERALL EXPERIENCE OF WORKING AT CARBC
  8. Declaration of interest
  9. References

First beginnings

The creation of CARBC was first recommended by a British Columbia government-appointed Task Group consisting of health practitioners, community partners and officials from five provincial ministries impacted by addictions. Tasked with studying and making recommendations on the future of addiction services in BC, the group was facilitated by the Kaiser Foundation. The Task Group's March 2001 report, Weaving Threads Together , made six recommendations to prevent and reduce harms from substance use and problem gambling. One recommendation was the creation of a centre for the advancement of addictions knowledge and practice. Receiving the report in March 2001, the government immediately approved funding for the creation of a new centre.

Several background factors were important to the formation of the Task Group. These included increasing overdose drug deaths, an epidemic of human immunodeficiency virus (HIV) and other blood-borne viruses and Vancouver's open drug market, one of the largest in the world. Fragmented government responses, together with shifting responsibility for prevention and treatment, led to a weak and ineffectual system. A lack of clarity and competing interests related to desired outcomes, approaches and contracting issues finally resulted in the Office of the Premier of British Columbia appointing the Task Group in December 2000.

By the time the report was completed, a provincial election was looming and opinion polls indicated strongly that the incumbent party was going to lose. None the less, the government acted quickly on the recommendation regarding research and knowledge exchange by allocating $10 million to create a charitable trust, the BC Addiction Foundation, charged with the task of establishing a new Centre. The BC Addiction Foundation invested the funds while they consulted how best to achieve their mandate. Proposals from several BC-based tertiary institutions were reviewed. The successful proposal eventually came from UVic, with its strong tradition of psychosocial and community-based research in areas such as health promotion, youth, ageing and indigenous health. The proposal was supported by three other major BC universities for the formation of a collaborative network of addictions researchers across the four campuses. UVic committed to make seven faculty appointments in the addictions area to provide capacity to the Centre. Despite some moments of high drama—signing papers moments before a midnight deadline and narrowly avoiding placing the money in a bank that later went bankrupt—the permanent transfer of funds to an endowment at UVic was completed in April 2005.

First members

Dr Bonnie Leadbeater, Professor of Psychology, led the development of the UVic proposal and was the founding director from November 2003 until a more permanent appointment was made following an international search. Tim Stockwell (Psychology), formerly director of Australia's National Drug Research Institute, was appointed as Centre director in mid-2004. Connie Carter supported the early development as the Centre's first administrator (2003–05).

The location of Victoria on beautiful Vancouver Island and the prospect of being part of something new soon attracted prospective scholars in the Canadian addictions field. Dan Reist was one of the first members to join the centre, bringing expertise in substance use and knowledge exchange. He brought his own funding and an office based in Vancouver shared with the Kaiser Foundation. Next came Scott Macdonald, an epidemiologist from the Ontario-based Centre for Addiction and Mental Health (CAMH) who was appointed assistant director. Shortly afterwards came Benedikt Fischer (Sociology) from the Toronto office of CAMH, with a senior scholar award from the Michael Smith Foundation. Rounding off the disciplinary expertise in this founding group was John Anderson (Community Medicine), who held a part-time position at the University of British Columbia's Faculty of Medicine and brought experience in education, general practice and drug policy. Site directors were appointed at other campuses, including Joy Johnson (Nursing, University British Columbia), Ray Corrado (Criminology, Simon Fraser University), Don Voaklander (Epidemiology, University of Northern British Columbia) and Jim Cullen (Psychology, Thomson Rivers University). Susan Boyd (Human and Social Development, UVic) facilitated activities with other faculty and graduate students located at the UVic campus.

Early development of operations and activities

Looking back over the first 5 years, there was a bewildering array of issues, priorities and opportunities to consider. There was a sense of huge support and hope for the Centre as well as high expectations to be met. Scores of prospective graduate students, government policy advisers, community organizations, established researchers and potential funders approached the fledgling organization with both requests and offers of collaboration. The CARBC Advisory Board (with representatives of our main stakeholders from government, not-for-profit agencies, consumer groups and academia) was and remains an invaluable source of guidance. Our Program Committee, comprising senior staff and site directors from other campuses, met initially up to four times a year to discuss early directions.

There are presently 19 research centres at UVic, a status which has to be approved by the Board of Governors for a 5-year renewable term. The Centre developed a Strategic Plan to identify core priorities and related activities as part of a successful application for Research Centre status for its first 5 years, 2006–10. Our plan was developed in close consultation with the Advisory Board, Program Committee and active addictions researchers in the province. The document (see http://www.carbc.ca) identified an overall mission statement, six core values and four key priority areas, each with identified activities and performance indicators to be reported annually. The core values underpinning social, ethical and intellectual dimensions were viewed collectively as important underpinnings to both our research and knowledge exchange activities. New members or affiliates who join the Centre are asked to sign their support for the core values and agree to report their research and knowledge exchange activities within the stated priority areas.

PRESENT CORE OPERATION

  1. Top of page
  2. ABSTRACT
  3. INTRODUCTION
  4. EVOLUTION OF THE CENTRE
  5. PRESENT CORE OPERATION
  6. DISSEMINATION, KNOWLEDGE EXCHANGE AND STAFF DEVELOPMENT
  7. REFLECTIONS ON THE OVERALL EXPERIENCE OF WORKING AT CARBC
  8. Declaration of interest
  9. References

Situation

CARBC is administered by the University of Victoria, with its head office on the outer edge of the Victoria campus on Vancouver Island, a 5–10-minute walk to most teaching departments, the library and university administrative buildings. Victoria is the province's capital city and is where the parliament and most ministries are based. Across the water in the city of Vancouver, we have a centrally located office where Dan Reist directs the CARBC Communication and Resource Unit with a staff of 10 policy analysts, information scientists and support staff. We also retain two site directors based in the cities of Prince George at the University of Northern British Columbia and Kamloops, the location of Thomson Rivers University.

Focus of activity

The essence of the Centre's mission is perhaps best captured by referring to the ‘mission statement’ and ‘core values’ expressed in our 2006–10 Strategic Plan [1].

Mission of CARBC

To create an internationally recognized centre distributed across BC that is dedicated to research and knowledge exchange on substance use, harm reduction and addiction.

Values of CARBC

(i) Collaborative relationships.  Dynamic, collaborative relationships are essential for maintaining relevance to the multi-faceted concerns related to substance use and addictions. Key relationships include those with policy makers, researchers from many disciplines, practitioners and people with direct experience of substance use, addictions and related problems.

(ii) Independent research.  Protection from vested interests is essential to ensure that rigorous research is conducted and communicated clearly with a view only to furthering the public interest. This will be ensured through excluding representatives of alcohol, tobacco and gaming industries from membership of the Advisory Board and not accepting direct research funding from such sources.

(iii) Ethics, social equity and justice.  Commitment to solid ethical principles governing internal and external relationships, financial management, the conduct of research and the communication of research findings.

(iv) Reducing risk and increasing protection.  Attention is required to both immediate factors (e.g. behavioural patterns and contexts) and distal factors (e.g. social, economic and developmental influences) to address effectively the harms from substance use and addictions across the life course.

(v) Harm reduction.  Recognition that some people will continue to use psychoactive substances and experience addictions, so that strategies are needed to reduce harmful consequences in addition to those that aim to directly reduce high-risk behaviours.

(vi) Informed public debate.  Commitment to informing public debate to achieve effective public policy on substance use and addictions through the communication of research findings.

Funding

In the financial year 2008/2009 CARBC received CAD$492 000 in interest payments from its endowment, which paid for core salaries and operations. A mix of external funding comprising approximately CAD$2.5 million was obtained from peer-reviewed national and provincial funding competitions and contract research.

Due to the economic downturn, in the present financial year (2009/2010) interest payments from the endowment were zero because the principal had fallen substantially below the initial amount of CAD$10.55 million. A contribution has been made by the Office of Research Services at UVic to maintain core operations. A substantially reduced core budget has been prepared and one support staff position has been lost. Strenuous efforts are being made to attract additional external funding in the meantime. Clearly, longer-term prospects hinge on the overall recovery of the financial markets.

Current programme of work

Again, we refer to our 2006–10 Strategic Plan [1] to illustrate some of the range of research and knowledge exchange activities undertaken at CARBC. The primary focus of the stated objectives is to benefit policy and practice in British Columbia. However, CARBC faculty have been engaged heavily in national and international activities (e.g. with the United Nations, the World Health Organization, international collaborations), which we see as complementary to rather than competing with CARBC interests.

Key Result Area 1: ‘To build research infrastructure and capacity across BC for the conduct of research that will increase understanding and support more effective responses to substance use’.

Types of indicators.  External funding, number and qualification of staff, number and progress of students, creation of data sets, engagement of external researchers and community members.

Highlights.  Staffing of the Centre across both offices increased from two to approximately 35 faculty, research and support staff. Funding increased from CAD$350 000 to slightly more than CAD$3 million per annum, balanced between government contracts (for knowledge exchange, policy development and epidemiological monitoring) and competitive peer-reviewed grants. A number of provincial data sets have been established as part of the BC alcohol and other drug monitoring system (see: http://www.AODmonitoring.ca), including detailed alcohol sales volume and price data by local health area, alcohol and other drug-attributable mortality and morbidity data, recurrent surveys of high-risk groups and emergency department attendees in the cities of Vancouver and Victoria.

Key Result Area 2: ‘To conduct high quality research that increases understanding of substance use and addiction and informs effective responses’.

Types of indicators.  Initiation and completion of projects in priority areas, evidence of collaboration provincially, nationally and internationally.

Highlights.  The BC monitoring project has been used by Health Canada as a pilot for the development of a national monitoring system. More locally, it has begun to generate data relevant to the evaluation of policies such as privatization of the BC liquor market [2] and public health impact of present taxation/pricing strategies [3]. A ‘New Emerging Team’ grant from the Canadian Institutes of Health Research has supported a range of different methodological approaches to this issue and the development of further successful funding application, including a focus upon patterns, functions and contexts of combined alcohol and cocaine use. Scott Macdonald has studied substance use in the work-place, alcohol and drug-related crime, substance use and injury. More recently, new faculty appointments in sociology (Cecilia Benoit and Mikael Jansson) have contributed studies of vulnerable populations and the effects of social stigma associated with substance use, poverty and homelessness, on individual health and wellbeing. Cheryl Cherpitel is developing a programme focusing upon substance use and injury presentations to emergency departments. John Anderson is working with local First Nations communities to find culturally appropriate ways of translating international research findings on the treatment and prevention of substance use problems. Clay Holroyd (Psychology) and PhD student Travis Baker are contributing a psychobiological dimension to our research profile with the development of a series of experimental studies using measures of brain activity to study the neural basis of addiction. A comprehensive list of CARBC related research projects and programmes can be found on http://www.carbc.ca.

Key Result Area 3: ‘To disseminate research findings that increase understanding of substance use and addiction, to increase awareness of related harms and to identify effective responses’.

Types of indicators.  Membership of research and/or policy committees (provincially and nationally), publication of comprehensive reviews, peer-reviewed (43 in 2007; 101 in 2008) and other publications, citations of peer-reviewed papers (317 in 2007; 609 in 2008), presentations, community dialogues, engagement of stakeholders in research planning and execution, media coverage and hits on the Centre's website.

Highlights.  We have produced a number of commissioned reports for provincial and federal governments covering topics such as tobacco control [4], prospects for additional supervised injection facilities [5], the implementation of employee assistance programmes in Canada [6], opportunities for alcohol taxation and pricing strategies [7], alcohol policy and harm minimization [8]. A provincial review of methadone prescribing services and policies has also just been completed by CARBC research associate, Tessa Parkes. We have produced statistical bulletins on trends in patterns of use, risk and related harms for alcohol, cannabis and other illicit drugs [9–11]. We have hosted and facilitated three international conferences, regular public seminars and various symposia or dialogue events. These activities generate approximately 400 media ‘hits’ per year. Members of the Centre work on provincial and national committees concerned with research and policy.

Key Result Area 4: ‘To contribute to the implementation of evidence-based policy and practice’.

Types of indicators.  Submissions and presentations to policy bodies, programmes introduced with CARBC contributing an evaluation component, policies and practices with evidence of possible influence from CARBC research and knowledge exchange.

Highlights.  It is easier to establish clear connections between our work and policy processes than in terms of outcomes. For example, we persuaded a federal senate report on mental health and addiction [12] to recommend a new tax on high-strength alcohol products. We generated editorial comment (much favourable) on proposals to price alcoholic drinks sold in government monopoly stores according to their alcohol content. We hosted a North American ‘Beyond 2008’ consultation as part of the United Nations review of policy on illegal drugs. We have also been involved closely in the development of written policy statements for government on the prevention and treatment of substance use problems and, in some instances, their implementation, including the work of the Alberta Gaming and Liquor Commission on the prevention of alcohol-related violence. There are also a handful of examples of specific policy impacts from CARBC activities including: the introduction of sterile equipment for crack smokers by some Canadian health authorities to prevent the spread of blood-borne diseases [5], the implementation of curriculum support materials for school drug education in BC (see http://www.iminds.ca), possible impacts on federal alcohol excise policy [7] and on provincial minimum pricing policies in Alberta and British Columbia. CARBC is active in developing pragmatic tools for a variety of practitioners that are based on the best available evidence. Examples of this work include alcohol and other drug-screening tools for use in school, campus and community settings, tools related to school-based education and policy and an initiative to provide community groups with web-based information and tools to understand substance use and prevent and respond more effectively to related risk and harm.

‘Best five publications’

CARBC produces a diverse range of publications and information resources designed for different audiences from which we have selected five examples, as requested by the commissioning editor. We believe in publishing in peer-reviewed journals as well as producing commissioned and other less formal reports, made available both electronically and in hard copy. We value collaboration and some papers co-authored across multiple institutions and countries which probably have had at least as much impact as those we feature here. These include a meta-analysis questioning the science underlying the purported health benefits of alcohol [13] and a summary paper of the evidence base for preventing harmful substance use by youth [14].

The Alcohol and Other Drug Monitoring Project Website (http://www.AODmonitoring.ca)

The aim of this electronic publication is to provide timely reports on patterns of substance use and related harms across place and time in British Columbia. Simple descriptive data are reported capturing the types of drugs most commonly used, hazardous patterns of use and major harms experienced. Alcohol sales data from the BC government monopoly are used to provide estimates of per capita consumption for 89 local health areas. Vulnerable population and general population surveys provide basic quantitative data on patterns of use, price and availability plus qualitative data on local trends. Using 16 health service delivery areas and five health authorities in the province, rates of alcohol, tobacco and illicit drug-caused mortality and morbidity are also reported over time and place. Crime data are being collected and reported. The website is a dynamic medium whereby data are reported more swiftly than with traditional publications. In addition to the simple descriptive data, rich data sets are being built up which are being shared with health and social researchers from a variety of disciplines and institutions for more in-depth analysis. Occasional statistical bulletins with colourful illustrations and written in ‘plain English’ have also been produced (e.g. [11]).

Two peer-reviewed journal publications

Macdonald et al.'s study [6] is the result of a Canadian collaboration on a drug policy issue of current concern. Segal & Stockwell [15] is an example of a student-led project that resulted in a peer-reviewed publication, was policy relevant and generated considerable media attention.

Two reports commissioned for government

Prepared for Dr Perry Kendall of the BC Ministry of Health, ‘A public health approach to alcohol policy: an updated report from the Provincial Health Officer’[8] has been well received and given close attention by political leaders and decision makers in the province and elsewhere in North America. Notably, one of its recommendations regarding the raising of minimum prices for spirits was implemented in February 2009, while others are under consideration. A substantial amount of the data reported was generated by the BC AOD monitoring project.

Stockwell et al. [7] was a report prepared originally as a briefing document for the development of a National Alcohol Strategy for Canada, published later as a CARBC technical report. It contributed to provincial and federal debates on alcohol tax and pricing policies.

Collaborating centres

Working collaborations have been established with other centres in BC, Canada and internationally. We have been particularly fortunate to be able to build collaborative relationships with the Alcohol Research Group in Emeryville, California, as well as the Prevention Research Center in Berkeley. We also have active collaborations with both the Centre for Addiction and Mental Health in Ontario and the National Drug Research Institute in Australia. The early model of having CARBC site directors located at other BC campuses has been replaced partly by these collaborating centres. Since the inception of CARBC, a number of other addiction-related research centres have sprung up elsewhere in BC: the Centre for Applied Research in Addiction and Mental Health at Simon Fraser University, a Leading-Edge Chair in Addiction Medicine at the University of British Columbia, the BC Mental Health and Addiction Research Institute located with the BC Provincial Health Services Authority and a research network focusing upon addictions and women self-led by the British Columbia Centre of Excellence for Women's Health. The research activities of these centres are largely complementary to those of CARBC and a number of collaborations have occurred.

DISSEMINATION, KNOWLEDGE EXCHANGE AND STAFF DEVELOPMENT

  1. Top of page
  2. ABSTRACT
  3. INTRODUCTION
  4. EVOLUTION OF THE CENTRE
  5. PRESENT CORE OPERATION
  6. DISSEMINATION, KNOWLEDGE EXCHANGE AND STAFF DEVELOPMENT
  7. REFLECTIONS ON THE OVERALL EXPERIENCE OF WORKING AT CARBC
  8. Declaration of interest
  9. References

Seminar series, conferences and colloquia

With the BC Mental Health and Addictions Research Network we organize eight to 12 public seminars per year which involve both CARBC faculty and external speakers. Topics have included: a harm reduction approach to tobacco, preventing violence around late-night premises, substance use interventions in indigenous communities, the evidence base for drug testing in the work-place, cannabis use and mental health, alcohol use and emergency room attendance and concurrent diagnoses of substance use and mental illness in vulnerable youth. We have hosted three international symposia and several 1-day events on special topics. We co-sponsor an annual research colloquium with the BC Mental Health and Addictions Research Network.

Teaching and collaboration with other centres/departments

CARBC faculty supervise students at all levels of study, mainly in addictions-related areas; several have reduced teaching loads (e.g. 20% of time) and some have adjunct faculty appointments with no teaching requirements. Plans are under way for a new interdisciplinary graduate programme entitled ‘Social Dimensions of Health Research’, which may have a specialist addictions stream. Collaborating staff from other departments, centres and universities are accorded CARBC Research Fellow status.

Attendance at national and international scientific meetings

The annual symposia and thematic meetings of the Kettil Bruun Society for Social and Epidemiological Research on Alcohol are attended frequently. CARBC has recently hosted both a thematic meeting and an annual symposium. CARBC members have also attended the annual meetings of the Society for Prevention Research, the Research Society on Alcoholism and the International Harm Reduction Association. Specialist disciplinary conferences, including Psychology, Public Health, Criminology and Sociology are attended frequently. The Canadian Centre on Substance Abuse hosts a biannual national conference for the alcohol and other drugs field at which CARBC members present frequently.

Staff development and subsequent career progression

Although it is still early days, only one senior staff member has left (to a senior position in the addictions field). We have had a talented and diverse group of junior researchers, several of whom have moved on to take full-time employment in government or more senior positions in research organizations. Efforts have been made to provide additional training and development experiences for the staff with opportunities to first author papers and present at conferences. We encourage junior staff to attend and gain credit for attending courses in research methods and statistical analysis.

Research dissemination and independence

As stated in our core values above, we aim to protect against undue influence of commercial or other vested interests and to promote academic freedom. We sometimes vote to endorse policy positions taken by other organizations, but we do not have party political positions on the many controversial issues in the field, nor are our own publications cleared externally. It is, of course, necessary to go into partnership with funding bodies on particular projects, usually government and occasionally non-government bodies concerned variously with public health, education, prevention or treatment in some way. Commissioned reports, by necessity, can be constrained by funding bodies, although even these have usually been published as independent centre reports once the project has been completed. In our experience, it tends to be the commissioned reports which are translated most readily into tangible outcomes. Our research findings are disseminated in a variety of ways in order to maximize the chance that they might be utilized by policy makers and practitioners. Our Vancouver office is occupied wholly with ‘translation’ or ‘knowledge exchange’, in which both the creators and consumers of knowledge collaborate at several stages of the research process to help ensure practically useful and relevant outcomes. In many instances, this appears to work best when the academic instinct to claim ownership by the first author is ceded either by sharing this with partners in the research process or abandoning it altogether. In the BC monitoring project we actively give away our intellectual property to encourage other researchers and policy analysts to mine our data sets. We encourage internal and external peer review for all of our reports and publications. Of course, the ultimate responsibility for accuracy and interpretation lies with the individual investigator/s.

Policy connections and impacts

These important objectives have been pursued variously by making formal submissions to government decision-making processes and reviews, encouraging membership of policy and research bodies at the provincial and national level, engaging in commissioned research activities in partnership with policy makers and hosting events at which researchers and policy makers and other interested parties discuss the significance of research knowledge. A number of performance indicators in our strategic plan underscore the centrality of the same. Members of the Centre have personally briefed Cabinet ministers, government committees and individual members of Parliament at both provincial and federal levels, in addition to the submission of written materials.

Ancillary activities

In conjunction with another tertiary institution, we have contributed to and supported a Summer Institute on addictions and mental health. The director is also co-leader of the BC Mental Health and Addictions Research Network, with a membership of more than 2000 researchers, government and health professionals and consumer groups. For the past 4 years, this Network has received between $250 000 and $500 000 per annum from the Michael Smith Foundation for Health Research. These funds have been used to provide travel bursaries for students, seed funding and development grants, the development of research supports which, to date, comprise a provincial epidemiological monitoring system, an inventory of recommended psychometric measures, advice on research and statistical methods, guidance on the use of a provincial database of all drug prescriptions and grants facilitation. CARBC is listed formally as a partner.

REFLECTIONS ON THE OVERALL EXPERIENCE OF WORKING AT CARBC

  1. Top of page
  2. ABSTRACT
  3. INTRODUCTION
  4. EVOLUTION OF THE CENTRE
  5. PRESENT CORE OPERATION
  6. DISSEMINATION, KNOWLEDGE EXCHANGE AND STAFF DEVELOPMENT
  7. REFLECTIONS ON THE OVERALL EXPERIENCE OF WORKING AT CARBC
  8. Declaration of interest
  9. References

Culture and philosophy

Our Centre is often associated from the outside with a philosophy of ‘harm reduction’ and, in particular, with the idea that a variety of regulatory approaches are more suitable than criminal sanctions alone to minimize harmful substance use and consequences. However, there is no party line and we encourage frank discussions of our differing definitions of ‘harm reduction’ and our philosophical assumptions. As a consequence, there are widely different points of view on matters of policy—whether in relation to alcohol, illegal drugs or gambling. A preparedness to give and receive criticism and respect for evidence and open debate might be better ways of describing the intellectual environment. One particularly strong ethic within the Centre is the desire for the work to be empirically based, relevant to the public interest and ultimately useful to the higher goals of promoting health and preventing, minimizing and treating problems related to substance use.

What makes the centre a good place to work?

Undoubtedly, this is both the people who work there and the opportunity to pursue research and knowledge exchange processes without undue interference or distraction.

We have good access to data on various populations, their patterns of substance use and related harms. Vancouver in particular is a major gateway for the transportation of illicit drugs across North America, has a notorious drug scene and BC is one of the heaviest alcohol-consuming provinces in Canada. In addition, there is a government alcohol monopoly that is slowly privatizing itself, but still supplying interested researchers with world-class data on alcohol sales. BC is also home of a variety of vulnerable populations—those social groups who suffer an additional burden of illness, distress and violence compared to other residents. Finally, the administration of the host university is open, accessible and supportive.

Good and bad days

Being a university-based researcher is an immensely rewarding and privileged occupation. On a good day everyone connected with the research process is receiving some benefits, the office is busy and buzzing, people are working together to achieve common objectives and enjoying their interaction with each other. Milestones are achieved, such as papers being accepted by peer-reviewed journals, data collection on a project is completed, a new grant awarded, and perhaps a promotion achieved. Some of the best days are when a public seminar or conference is hosted and new work is received with interest and praise, with many colleagues from the wider community present. Occasionally, and usually quite unexpectedly, it appears that some of our research has been used to make a difference to policy—minimum bar prices have been introduced in Alberta or clean crack smoking paraphernalia is being distributed to prevent the spread of blood-borne viruses in Nanaimo, BC. People outside our Centre contact us requesting more information or advice on what they are doing. Invitations to present findings are received from interesting places. A meeting with collaborators happens with shared excitement about mutual progress and perhaps new insights and new hypotheses to test. A former staff member or student drops in, perhaps with a baby or toddler in tow—or both. A student graduates with distinction. From the office window is a peerless view of snow-capped mountains, the ocean shimmers in the distance and all is well with the world.

And on a bad day . . . well, these happen. A little conflict develops in the office, an ethics committee finds baffling moral problems with a harmless study, you are given a long and incomprehensible paper to read or review, you have 10 simultaneous deadlines and no time, the Dow Jones Index has plummeted again, the reviewers did not like your paper, a grant application was turned down, and one of your favourite staff members is leaving to live in Winnipeg. E-mails are flooding in at about 20 per hour, many looking disturbingly like more work, and Manuscript Central (now called ScholarOne Manuscripts) in particular is becoming increasingly insatiable in its demands. There is somebody gardening outside in the campus grounds, sunshine lights their work and you look on enviously.

Lessons learned

A steep part of the learning curve for Centre management has been the negotiation of affiliated university faculty appointments committed to by UVic when it won the right to host CARBC. Competition emerged between the Centre and some departments over these appointments, as no process had been established to ensure that the addictions research agenda was well represented in the selection procedure. Only three full-time faculty positions out of the potential for seven have been filled to date, with a further four adjunct faculty appointments supporting the work of the Centre. Negotiations are under way with key departments at UVic for the establishment of genuinely shared appointments within a fully collaborative process that meets the needs of both the Centre and the departments concerned. An alternative model in place at the Centre for Aging at UVic involves recruiting specialist researchers to such positions with the expectation (realized successfully in most cases) that they apply for professional salary awards, thereby justifying substantially reduced teaching loads necessary to support the research mission. This strategy may not bear fruit in the short term, given the adverse financial climate for universities in Canada, but could lead to further success in the longer term. An improved mutual understanding of this problem has been achieved between the Centre and senior management of the university and a more collaborative approach is being pursued between the centre and key departments.

From a leadership perspective, the present director (and first author) had to learn that the funding and policy environments as well as the host institution were very different to what he had been accustomed to in Australia. At one level there is more independence, as there is no federal body to approve annual work plans and level of funding. The downside of this, however, is that it is necessary to work harder to forge relationships with policy makers, both provincially and federally. There are many cultural and institutional differences between Australia and Canada which have had to be learned and understood.

Succession planning

The policy for research centres at UVic determines that a Centre director has a 5-year appointment which is normally only renewable once. Both the Director and Assistant Director's appointments have been renewed recently for 5-year terms. With these arrangements and a probable increase of CARBC faculty over the next 5 years there should be no shortage of candidates to assume these and other leadership positions in the future. Another direction is likely to be a more systematic contribution to graduate training through participation in the planned interdisciplinary health research programme, with a probable speciality in addictions. In time this should, along with a corps of talented graduate students presently under supervision at CARBC, help to develop the next generation of addictions researchers in British Columbia.

The future

Priorities for development of the Centre over the next few years will include the development of graduate research programmes in addictions and attracting new scholars to faculty positions both at UVic and the Centre. We will strive to build our research infrastructure in terms of databases to be made available to other researchers in the province and elsewhere in North America. We will also continue our established tradition of attempting to integrate research and knowledge exchange activities so as to better inform and improve policy and practice responses to the problems of substance use in British Columbia and, hopefully, elsewhere.

Declaration of interest

  1. Top of page
  2. ABSTRACT
  3. INTRODUCTION
  4. EVOLUTION OF THE CENTRE
  5. PRESENT CORE OPERATION
  6. DISSEMINATION, KNOWLEDGE EXCHANGE AND STAFF DEVELOPMENT
  7. REFLECTIONS ON THE OVERALL EXPERIENCE OF WORKING AT CARBC
  8. Declaration of interest
  9. References

The authors' salaries are paid mainly by the University Victoria, one (M.J.) from a grant from the Canadian Institutes of Health Research and one from BC government contracts. Our research is supported by a mixture of provincial and federal government funding contracts and peer-reviewed grant competitions from health research funding organizations.

References

  1. Top of page
  2. ABSTRACT
  3. INTRODUCTION
  4. EVOLUTION OF THE CENTRE
  5. PRESENT CORE OPERATION
  6. DISSEMINATION, KNOWLEDGE EXCHANGE AND STAFF DEVELOPMENT
  7. REFLECTIONS ON THE OVERALL EXPERIENCE OF WORKING AT CARBC
  8. Declaration of interest
  9. References
  • 1
    Centre for Addictions Research of BC. A Framework for Addictions Research and Knowledge Exchange in British Columbia. CARBC Strategic Plan for 2006–2010. Victoria, BC: University of Victoria; 2006.
  • 2
    Stockwell T., Zhao J., Macdonald S., Pakula B., Gruenewald P., Holder H. Changes in per capita alcohol sales during the partial privatization of British Columbia's retail alcohol monopoly 2003–2008: a multi-level local area analysis. Addiction 2009; 104: 182736.
  • 3
    Stockwell T., Pakula B., Macdonald S., Buxton J., Zhao J., Tu A. et al. Alcohol Consumption in British Columbia and Canada: A Case for Liquor Taxes That Reduce Harm. CARBC Statistical Bulletin no. 3. Victoria, BC: University of Victoria; 2007.
  • 4
    Population Health and Wellness. Evidence Review: Healthy Living—Tobacco Control. Core Public Health Functions for BC. Victoria, BC: BC Ministry of Health; 2006.
  • 5
    Fischer B., Powis J., Firestone Cruz M., Rehm J. Hepatitis C virus (HCV) detection on crack use paraphernalia. Eur J Gastroenterol Hepatol 2008; 20: 2932.
  • 6
    Macdonald S., Csiernik R., Durand P., Wild T. C., Dooley M., Rylett M. et al. Changes in the prevalence and characteristics of Ontario workplace health programs: 1989–2003. Journal of Employee Assistance and Workplace Behavioural Health 2007; 22: 53.
  • 7
    Stockwell T., Leng J., Sturge J. Alcohol Pricing and Public Health in Canada: Issues and Opportunities. CARBC Technical Report. Victoria, BC: University of Victoria; 2006.
  • 8
    Office of the BC Provincial Health Officer. A Public Health Approach to Alcohol Policy: An Updated Report from the Provincial Health Officer. Victoria, BC, Canada: BC Ministry of Health; 2008.
  • 9
    Stockwell T., Sturge J., Macdonald S. Patterns of Drinking in British Columbia: An Analysis of the 2004 Canadian Addictions Survey. CARBC Statistical Bulletin no. 1. Victoria, BC: University of Victoria; 2005.
  • 10
    Stockwell T., Sturge J., Jones W., Carter C. Cannabis use in British Columbia: patterns of use, perceptions and public opinion as assessed in the 2004 Canadian Addiction. CARBC Statistical Bulletin no. 2. Victoria, BC: University of Victoria; 2006.
  • 11
    Martens L., Stockwell T., Buxton J., Duff C., Macdonald S., Richard K. et al. Regional Variations and Trends in Substance Use and Related Harm in BC. CARBC Statistical Bulletin no. 4. Victoria, BC: University of Victoria; 2008.
  • 12
    Kirby M., Keon W. J. Out of the shadows at last: highlights and recommendations. The Standing Senate Committee on Social Affairs, Science And Technology, Senate of Canada: Ottawa; 2006. Available at: http://www.parl.gc.ca/39/1/parlbus/commbus/senate/com-e/soci-e/rep-e/pdf/rep02may06high-e.pdf (accessed 14 May 2009).
  • 13
    Fillmore K. M., Kerr W. C., Stockwell T., Chikritzhs T., Bostrom A. Has alcohol been proven to be protective against coronary heart disease? Responses to eight commentaries. Addict Res Theory 2007; 15: 3546.
  • 14
    Toumbourou J. W., Stockwell T., Neighbors C., Marlatt G. A., Sturge J., Rehm J. Interventions to reduce harm associated with adolescent substance use: an international review. Lancet Adolescent Health Series no. 4, 2007; 369: 4151.
  • 15
    Segal D. S., Stockwell T. Low alcohol alternatives: a promising strategy for reducing alcohol related harm. Int J Drug Policy 2009; 20: 1837.