Alberta eyes legislation on involuntary treatment for some drug users

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The Alberta government is considering introducing a law that would broaden the circumstances under which people with severe drug addictions could be placed into treatment without their consent.

The legislation would be the first involuntary treatment law in Canada to target addiction specifically. Some jurisdictions, including Alberta, already use mental-health law to push people into drug treatment without court orders in exceptionally severe situations. But otherwise adult drug users can refuse help.

Government documents obtained by The Globe and Mail through an access-to-information request suggest the potential change in Alberta would give police, as well as the family members or legal guardians of drug users, sweeping rights to refer adults and youth to involuntary treatment if they pose risks to themselves or others.

The United Conservative Party government, under Premier Danielle Smith, refers to the potential legislation as the “Compassionate Intervention Act.” The documents, which cover the time period from Oct. 6 (when Ms. Smith won the UCP leadership vote) to Dec. 15, suggest the government expected to introduce the bill in the legislature at some point this year.

Colin Aitchison, a spokesperson for Alberta Minister of Mental Health and Addiction Nicholas Milliken, said an expansion of involuntary treatment is still under consideration. The government has “explored a variety of options, including the potential development of a Compassionate Intervention Act,” he said in a statement. “As of this time, no decisions have been made by the Government of Alberta.”

Alberta’s legislature is currently adjourned, and the UCP and New Democratic Party are steeling themselves for a May 29 general election that is shaping up to be a tight race. Any new legislation would have to wait until after Albertans go to the polls.

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The nearly 450 pages of records are a mixture of reports and e-mails between Ministry of Mental Health and Addiction officials, including Coreen Everington, who was then executive director of the ministry; Bryce Stewart, who was then deputy minister; and Evan Romanow, who was then assistant deputy minister. The documents detail the government’s internal discussion of involuntary drug treatment. They include reports on the effectiveness of Alberta’s existing youth involuntary treatment program and drug treatment courts.

Within the documents is a review of existing laws in Australia, Portugal, Massachusetts and Washington State. That review includes details of a proposed process for Alberta to use in deciding whether to grant applications for involuntary treatment. An administrative panel, and potentially a separate Indigenous-focused panel, would hear those applications. This would be similar to what is done in Portugal.

The allowable periods of confinement in the province, and whether they could be extended, was “to be determined” at the time.

Also contained in the documents is an outline of a process under which a person could be taken in for involuntary treatment. The records say drug users could be forced into treatment after committing non-violent criminal or statutory offences “primarily as a result of a substance use disorder,” or when law enforcement, family members or legal guardians believe they are “at risk of serious harm to themselves or others as a result of substance use disorder.”

Since becoming Premier, Ms. Smith has made dealing with crime and social disorder, which she has said are related to drug use, a key focus of her government.

The UCP has centred its addictions strategy on detoxification, treatment and recovery. At the same time, it has restricted certain harm-reduction measures, such as supervised consumption sites. But it has not yet produced data that demonstrate whether this path has been successful.

The government’s strategy includes building nine mental-health and addiction recovery communities. Only one of them, in Red Deer, is completed. It has yet to open.

While several of Ms. Smith’s ministers have hinted at the possibility of forced treatments as a way of addressing the country’s toxic drug crisis, none have mentioned potential legislation. More than 1,600 Albertans died from unintentional drug overdoses last year – a 12-per-cent decrease compared with 2021, but still far above prepandemic levels.

Rachel Notley, the Leader of the Alberta NDP, said in a statement that although drug poisonings have devastated families, the changes being contemplated by the government would be too punitive.

“Imprisoning Albertans against their will for addiction treatment is doomed to failure, both from a treatment perspective and a legal one,” she said. “Effective and lasting treatment meets people where they’re at and supports them in taking a different path. I strongly expect that the courts would strike down an approach that forcibly confines Albertans who have not been convicted of a crime.”

Leaders in other parts of Canada, including Toronto and British Columbia, are also debating expanding involuntary treatment for complex mental-health and addictions issues, despite controversy around the practice. But none have introduced new laws to do so.

In B.C., critics have noted that there were widespread human rights violations at what were then called “asylums” for mentally ill people, before those facilities were deinstitutionalized. They say forced treatment will further criminalize vulnerable populations, putting them at risk of even more harm.

One report in the Alberta documents highlights the fact that several rights protected in the Charter of Rights and Freedoms are “potentially at odds” with involuntary treatment, including the right to life, liberty and security, and the right not to be arbitrarily detained.

Since 2006, Alberta has allowed parents or legal guardians of young people to petition courts to place them into involuntary treatment for drug or alcohol use through protective court orders. If such an order is granted, authorities can apprehend the child and transfer them to a “safe house” for up to 15 days, where they undergo detoxification, stabilization and assessment.

The province’s existing Mental Health Act allows for involuntary detainment only in extreme cases, when health care providers deem people to be at risk of suffering significant mental or physical deterioration, or causing harm to others. People designated under the act who are using substances have the right to refuse drug treatment if they have the capacity to understand the risks of drug use.

B.C. Premier David Eby has said he believes creating more involuntary treatment programs, in facilities such as the Red Fish Healing Centre, is one way to improve public safety while helping a small group of repeat violent offenders, most of whom are experiencing homelessness, mental-health issues and addiction – or all three personal crises at once.

Mr. Eby told The Globe’s editorial board earlier this year that he wants to expand the scope of the province’s Mental Health Act.