乔丹·考丘克从未想过，54 岁的自己还会有室友，更别说十几个室友了。
Jordan Kawchuk didn’t imagine having a roommate at the age of 54, let alone more than a dozen of them.
但在 2026 年初的六个月里，他的家是位于不列颠哥伦比亚省纳奈莫的温哥华岛治疗社区（VITC），一家专门收治男性的戒瘾中心。
But for six months at the start of 2026, his home was the Vancouver Island Therapeutic Community (VITC), a treatment centre for men in Nanaimo, B.C.
当考丘克——一位作家兼前电视制片人——在一次探访中接受 CBC 音频纪录片组采访时，他身穿一件蓝色扣领衬衫，发型整齐利落。他说自己常被误认为是工作人员。
When Kawchuk, a writer and former TV producer, met with CBC’s Audio Documentary Unit during a visit to the treatment centre, he was wearing a blue, button-down shirt, his hair neatly coiffed. He said he often gets mistaken for a member of the staff.
但这其实是他第二次入住该机构，也是他在与酒精使用障碍抗争的几十年间尝试的第五个住院治疗项目。
But it was actually his second time at this facility and the fifth in-patient program he’s tried during his decades-long struggle with alcohol-use disorder.
考丘克列举了一长串多年来因酒精而失去的东西。他说自己被无数份工作解雇；损失了大量金钱和信任。但他说最难过的是失去了婚姻，以及女儿们成长过程中全天候陪伴她们的机会。
Kawchuk has a long list of things he’s lost to alcohol over the years. He says he’s been fired from countless jobs; he’s lost a lot of money and trust. But he says the hardest part was losing his marriage and the opportunity to live full time with his daughters when they were growing up.
而他绝非孤例。研究显示，酒精使用每年给加拿大社会造成约 200 亿加元的损失，涵盖医疗保健、生产力损失和刑事司法成本。
And he’s far from alone. Research shows that alcohol use costs Canadian society around $20 billion a year in health care, lost productivity and criminal justice costs.
尽管根据加拿大统计局数据，总体酒精消费量略有下降，但饮酒者却喝得更多了。
Although consumption of alcohol is ticking down slightly overall, according to Statistics Canada, those who do drink are drinking more.
由成瘾与心理健康中心（CAMH）研究人员开展的一项全国性研究，于今年早些时候发表在《精神药理学杂志》上，发现酒精在加拿大造成的总体危害超过任何其他药物，远超非处方阿片类药物或烟草。
A national study conducted by researchers from the Centre for Addiction and Mental Health (CAMH), published earlier this year in the Journal of Psychopharmacology, found that alcohol causes more harm overall than any other drug in the country, far more even than non-prescription opioids or tobacco.
加拿大健康信息研究所（CIHI）表示，每天约有九人在加拿大医院因酒精造成的危害而死亡。因酒精住院的日均人数为 280 人，而阿片类药物仅为 84 人。
The Canadian Institute for Health Information (CIHI) says around nine people die in Canadian hospitals each day from harm caused by alcohol. Daily hospitalizations for alcohol number 280, compared to 84 for opioids, it says.
此外，加拿大近18%的15岁及以上人口在其一生中将符合酒精使用障碍的临床诊断标准。尽管如此，一些医生和倡导者表示，受酒精问题困扰的人们并未获得有科学依据支持的治疗选择。
On top of that, nearly 18 per cent of people aged 15 years or older in Canada will meet the clinical criteria for an alcohol-use disorder in their lifetime. Still, some doctors and other advocates say people struggling with alcohol aren’t getting treatment options that are backed by science.
医生需要做得更好，成瘾医学专家表示 艾文·艾隆医生就是其中之一。他在温哥华岛经营着唯一一家专门治疗酒精使用障碍（AUD）的诊所。他表示，患者通常不是他工作中最困难的部分。
Physicians need to do better, addiction doc says Dr. Evan Ailon is one of them. He runs the only dedicated practice on Vancouver Island for alcohol-use disorder (AUD). And he says the patients are not usually the hardest part of his job.
“我面临的挑战来自那些缺乏信息、缺乏相关知识的同事，这严重阻碍了这些患者的治疗。”艾隆表示，寻求酒精问题帮助的人往往面临污名化和边缘化。他的患者告诉他，家庭医生要么忽视他们的饮酒问题，要么只是建议他们少喝点。
“The challenges that I have are with colleagues whose lack of information, lack of knowledge about this really gets in the way of the treatment of these patients.”Ailon says people seeking help for a problem with alcohol often face stigma and marginalization. His patients tell him that family doctors have ignored their alcohol use or just advised them to cut down.
他表示，自己也对患者常被建议仅去参加匿名戒酒会感到沮丧。他说，虽然这类互助小组对某些人有效，但不应成为唯一提供的选择。
He says he’s also frustrated that patients are often advised to simply go to Alcoholics Anonymous. While support groups like that do work for some people, they shouldn’t be the only thing offered, he says.
“医学史上一些最有效的药物，毫无例外，都是针对酒精使用障碍的，但大多数医疗提供者并不知情，普通大众更是不知情。”例如纳曲酮，该药于1997年获加拿大卫生部批准，作用于大脑的阿片类奖赏中心，减少渴求。它帮助人们减少饮酒量，并降低康复者的复发几率。
“Some of the most effective medications that have ever been invented in medicine, full-stop, are for alcohol-use disorder, but that is just something that's not known by most providers and certainly not known by the average person.”Naltrexone, for example, which was approved by Health Canada in 1997, affects the brain’s opioid reward centre, decreasing cravings. It helps people reduce consumption, and for those in recovery, reduces the chance of relapse.
阿坎酸于2007年获批，通过恢复因长期饮酒而失衡的神经递质平衡来改善戒断症状。它用于维持戒酒状态。
Approved in 2007, Acamprosate improves withdrawal symptoms by restoring balance between the neurotransmitters that get out of whack with chronic alcohol use. It's used to maintain abstinence .
同样在医院工作的艾隆表示，他所见到的死亡病例往往是可以预防的。
Ailon, who also works in hospitals, says the deaths he sees are often preventable.
“我会看到一位因严重肝衰竭入院的患者，在病历里我能看到他们曾多次因肝衰竭入院……，”艾隆说。
“I'll see a patient who comes in with severe liver failure and I can see in the chart that they've had multiple admissions for liver failure…,” says Ailon.
但他表示，通常在病历中找不到任何关于酒精使用障碍治疗的记录。
Yet he says he usually finds no mention of treatment for alcohol-use disorder.
“如果我们医生接诊一位因糖尿病控制极差而导致足部麻木和心脏病发作的患者，我们在病历里写道：‘尽管我们告知患者需停止摄入糖分，但患者仍继续食糖’，而我们从未给他们开具任何治疗糖尿病的药物，这将是难以置信的不可接受。然而对于物质使用障碍，这种情况却完全被常态化了。”成瘾与心理健康中心（CAMH）表示，据估计，接受适当药物治疗的酒精使用障碍患者不足2%。
“If we as physicians had a patient who came into the hospital with numb feet and a heart attack from very poorly controlled diabetes and we wrote in our charts, ‘this patient continues to eat sugar, despite us telling them they need to stop eating sugar,’ but we've never started them on any of the medications that we have for diabetes, that would be unbelievably unacceptable. Yet for substance use, it's completely normalized.”CAMH says it’s estimated that less than two per cent of people with AUD get appropriate medications.
2023年共同主持制定高风险饮酒治疗新指南委员会的CAMH高级科学家于尔根·雷姆表示，这种病症通常不被识别。
Jürgen Rehm, a CAMH senior scientist who in 2023 co-chaired a committee that developed new guidelines for treating high-risk drinking, says the condition usually goes unrecognized.
“因为主治医生不询问，患者也不提及酗酒问题……总体而言，高风险饮酒、重度饮酒和酒精使用障碍在我们的医疗体系中没有被足够早地识别出来，”雷姆说，他同时也是多伦多大学达拉·拉纳公共卫生学院的教授。“我见过人们翻白眼”乔丹·考克亲身经历过这种情况。
“Because neither the treating physician asks, nor the patient mentions alcohol problems …, overall high-risk drinking, or heavy drinking and alcohol-use disorders, are not being recognized early enough in our health-care system,” said Rehm, who is also a professor at the University of Toronto’s Dalla Lana School of Public Health. ‘I’ve seen people roll their eyes’Jordan Kawchuk has experienced that first hand.
“我去过急诊室，护士或安排床位的人会说：‘我们得把床位留给病情比你更严重的人’，或者我听到他们说：‘又来一张床，又一个瘾君子，又一个酒鬼。’ 甚至很难开口说酒精使用障碍是一种疾病，因为我见过人们翻白眼。”加拿大广播公司（CBC）曾请加拿大医学会和加拿大家庭医生学院就国内酒精治疗现状置评，但两个机构均拒绝回应。艾隆表示，他也担心患者被送往昂贵的住院治疗项目。
“I've been to emergency rooms where nurses or whoever gives me a stretcher or a bed has said, ‘well, we need this bed for people with more problems than you,’ or I overhear them saying, ‘another bed, another addict, another drunk.’ It's hard even saying that alcohol-use disorder is a disease because I've seen people roll their eyes.”CBC asked the Canadian Medical Association and the College of Family Physicians of Canada to comment on the state of alcohol treatment in this country, but both organizations declined. Ailon says he also worries about patients being sent to expensive in-patient treatment programs.
“当我看到人们花费4万美元接受治疗，而效果却不如门诊治疗时，这显然让我有些犹豫……。”他说确实有患者通过这些项目得到了帮助，但重要的是要找到驱动酗酒的根本原因。
“When I see people who are dropping $40,000 on something that is no better than what they can do as an out-patient, it obviously makes me a little bit hesitant….”He says he does have patients who were helped by the programs, but it’s important to get to the root of what’s driving alcohol use.
“你可以让某人参加为期三个月的项目……但如果在……这三个月结束时，你把他们送回最初导致问题的完全相同的环境中，结果无法解决问题也就不足为奇了。”Chris Kinch表示，他同意住院治疗并不适合所有人。他是运营VITC的非营利组织Connective的副总裁，Kawchuk曾两次入住该机构。
“You can put somebody in a three-month program … but if you, at the end of … those three months, put them back into exactly the same circumstances that they came from that were driving the issue, it's not at all surprising that it doesn't fix the problem.”Chris Kinch says he agrees in-patient treatment isn’t for everyone. He’s a vice-president at Connective, the non-profit that runs VITC, where Kawchuk has been twice.
那里的治疗是免费的，他说之所以对某些人有效，是因为核心在于建立社区。
Treatment there is free, and he says it works for some people because it’s all about building community.
“因此，个人拥有高度结构化的日程安排，他们参加会议、相互合作、相互监督，”Kinch说。
“So individuals have a highly structured day where they're attending meetings, they're working with each other, holding each other accountable,” Kinch said.
“社区是所采用的治疗方法。”这些男性可以接受心理咨询和团体治疗。但这也关乎教授他们社交技能，以便他们离开治疗中心后能为社区做贡献，他说。
“Community is the method of treatment that's used.”The men have access to counselling and group therapy. But it's also about teaching them social skills so they can contribute to their communities when they leave treatment, he says.
Jordan表示，住院治疗给了他休息、恢复和自我提升所需的空间。
For Jordan, being in treatment gives him the space he needs to rest, recover and work on himself, he says.
在VITC待了近六个月后，Jordan说他在6月份觉得已经准备好回家了。他的第一站是去不列颠哥伦比亚省奥卡纳根地区看望女儿们。
After almost six months at VITC, Jordan says he felt ready to go home in June. His first trip was to visit his daughters in the Okanagan region of B.C.
“我不在乎事业，也不在乎重返电视行业、发财或买房。我唯一想要的就是与孩子们建立关系，”他说。“现在是时候作为成年人去了解他们了。”他说自己正在按时服药、参加AA会议，并撰写一本关于他与酒精使用障碍抗争的书。
“I don't care about the careers or getting back to making television or getting rich or owning a home. That's the only thing I want,” he says of fostering a relationship with his kids. “Now it's time to get to know them as adults.”He says he’s taking his medication, going to AA meetings and writing a book about his struggle with alcohol-use disorder.
“我只能保持警惕。我必须明白这是生死攸关的事，因为这种疾病想要我的命。”
“I just have to be diligent. I have to know that it is life and death because the disease is out to kill me.”