With illicit drug use, homelessness and untreated mental illness reaching a crisis in parts of Canada, the governments of at least three provinces want to treat more people against their will, even as some health experts warn involuntary care for drug use can be ineffective and harmful.
This month, British Columbia’s premier, whose party is in a tight race for reelection in the province, said his government would expand involuntary treatment for people dealing with mental illness combined with addiction and brain injuries due to overdose. Some would be held in a repurposed jail.
The Alberta government is preparing legislation that would allow a family member, police officer or medical professional to petition to force treatment when a person is deemed an imminent danger to themselves or others because of addiction or drug use.
And New Brunswick has said it wants to allow involuntary treatment of people with substance use disorders, although it, too, has yet to propose legislation. A spokesperson for the governing Progressive Conservative party, which is also running for reelection, called this “compassionate intervention.”
Robert Tanguay, an addictions psychiatrist and clinical assistant professor at the University of Calgary, supports involuntary care under certain conditions but also stressed more voluntary treatment options are needed.
Tanguay was a member of Alberta’s Recovery Expert Advisory Panel that helped shape government policy on addiction and mental health care, and said opinions about the efficacy of involuntary care varied.
“The one thing that was all agreed upon is it has to be done compassionately and in the healthcare system, not in the penal system,” Tanguay said. “We can’t just incarcerate people using drugs.”
This makes sense to me.
There’s a risk that police will weaponize an ability to commit someone to involuntary rehab. There’s a risk that overdoses might go unreported because people want to avoid being committed to a facility. The question is if these risks will be outweighed by any benefits. I think it’s unfortunate that these programs aren’t being discussed by political parties in practical terms. There’s just a lot of handwaving about whether or not it will ‘work’, and no real discussion of the objectives and expected outcomes.
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The cause of addiction is not drugs.
This is a very strange take.
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I understand the view that in rehabilitation from addiction, drugs are not the only factor to consider. But they are absolutely a factor that needs to be considered. Ask anyone who has tried to quit smoking, drinking, or using any drug.
If someone overdoses and almost dies, or harms someone else, I think the state has a responsibility to get that person help that they may not have the ability, knowledge, or desire to seek, as opposed to turning them back out onto the street and waiting for it to happen again. The situation right now where I live is that businesses and homes are stocked with naloxone kits, and citizens are administering lifesaving healthcare to people on death’s door, on the sidewalk. Everyone I know who lives downtown has seen a dead body on the street in the past year. That’s not good, and practical solutions are needed immediately. I’m not convinced that a Swiss bulletin from 1999 which tents its argument on examples from the Vietnam War and the American Civil War really gets to the heart of the current issue and set of circumstances.
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You’re making personal assumptions about me, and the internal mental states of others that I think are unfair.
I don’t want to see overdoses in the street, nobody should. Not because I want it to happen in private, but because I don’t want it to happen. For the record, and not that you asked, but, I’ve also never said that I’m an advocate for mandatory rehab, or that it’s some kind of magical cure-all. I’m not here carrying water for these initiatives. All I’m saying is that there’s a serious problem, and a need for solutions and sincere discussion. I don’t think anything is gained for any position by browbeating others and fabulating their inner thoughts.
This was course material to a post grad university course on the subject of addiction and recovery taught THIS MONTH. It discusses the entire history of opiods.
Interesting. Can you link the course? I’d be curious to see the syllabus and learn more.
The problem with the current program is that we did a “half Portugal” where we stopped with enforcement because it was cheaper, and also didn’t put in funding for support and treatment because because they (the goverment) thought is was cheaper.
The problem with this, knowing that our government is cheap. They’ll talk about enforcement, but will be super cheap about it. I’d actually be more worried about this endeavour if I thought they were going to fund it adequately.
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What evidence do you have for this?
This is such a ridiculous proposition. The people who want treatment can’t get it. Are we going to take the overworked doctors away from patients in order to forcibly treat drug addicts?
Nobody gets clean while sleeping rough.
https://homelesshub.ca/collection/programs-that-work/housing-first/
https://endhomelessness.org/resource/data-visualization-the-evidence-on-housing-first/
And here is a podcast by and about drug users where people speak about their experiences with the system in BC and elsewhere as is has been, is, and is becoming: https://www.crackdownpod.com/ Includes interviews with researchers and doctors.
I have found it extremely worthwhile and necessary listening, but it is heartwrenching.
Nothing about them without them.
A few years ago I would’ve been pretty disgusted with this, but now with frequent contact with entrenched homeless I think it’s needed.
There are those few that just seem to be stuck in addiction and anti-social behavior and permanent incarceration or exile are about the only other options. You’d need some robust safeguards though so that it’s only used as that last resort after exhausting other options.
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Or Canada could fix
Surely you mean “and”? I may not have been clear in my previous comment but my point is there is a very small minority that can’t be helped in the other ways. That doesn’t mean you shouldn’t also do all the other things since it’s just a very small group that can’t be helped that way and that’d be silly.
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This doesn’t help the people already stuck. On these drugs, homeless, and dealing with the mental health issues that come with that is a huge burden, even if we fixed the issuess that push people into these addictions, they may not be able to get out of these situations on their own. Things like getting housed or employed become increasingly difficult when homeless and addicted. Ideally these involuntary treatments include housing treated people and assisting them in getting their own housing and employment.
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“Ideally these involuntary treatments include housing treated people and assisting them in getting their own housing and employment.”
…yeah but they won’t, will they?
allow a family member, police officer or medical professional to petition to force treatment when a person is deemed an imminent danger to themselves or others because of addiction or drug use
As long as there are some seriously strict requirements that need to be met then it’s better than what we have at the moment.
There absolutely will not be.
The intent is to be able to go out, round up the homeless in vans, and toss them into a ‘treatment’ centre. Taking street drugs is inherently dangerous, and so if you’re using, you’re eligible. If it turns out that you’re clean but have untreated mental health issues, then you’ll get held against your will for the safety of those around you.
I mean, they might as well start tracking these people by tattooing them - maybe with a bar code on their wrist.
I’m not sure how these are different from already existing psych holds?
