Experts weigh in on Alberta considering involuntary treatment

Open this photo in gallery:

Experts in addictions, law and criminology are rebuking the Alberta government over potential legislation that would force people into drug treatment against their will, calling it “incarceration rebranded.”

They said such legislation would threaten people’s Charter-protected rights and could increase the likelihood of relapse and overdose.

The United Conservative Party government refers to the proposed law as the Compassionate Intervention Act. The first legislation in Canada specifically aimed at involuntary treatment for people dealing with addictions would give police, family members or legal guardians the power to refer adults or youth to involuntary treatment if they pose a risk to themselves or others.

The proposed new law, which couldn’t be introduced until after Albertans head to the polls in a general election on May 29, was revealed in documents obtained through access-to-information requests by The Globe and Mail. If enacted, 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 by referral.

The UCP government has stated that the act remains under consideration.

Elaine Hyshka, associate professor at the school of public health at the University of Alberta, said there are a number of concerns with the potential law. She said there is no evidence to suggest that forced care is effective in comparison to voluntary care and that it increases the risk of death after discharge.

“Any time we’re moving in the direction of suspending people’s civil liberties and infringing on their human rights, we have to have pretty strong evidence that the action we’re going to take will be helpful and not harmful to them,” Dr. Hyshka said.

“We just don’t have that evidence in the case of involuntary confinement for substance use.”

She said the government should turn to already-proven methods to reduce drug harms, such as expanding naloxone distribution, supervised consumption services and injectable opioid agonist medications.

Colin Aitchison, a spokesperson for Nicholas Milliken, Minister of Mental Health and Addiction, said on Tuesday the government has “nothing further to add” in response to a list of questions from The Globe on the potential legislation’s framework and intent.

Public Safety Minister Mike Ellis slammed harm reduction interventions, such as supervised consumption sites and safer supply programs, during an unrelated news conference on Tuesday. He pointed to Vancouver’s Downtown Eastside as proof of what he considers “failed policies” and as reason to explore alternative approaches, such as the act.

“It would be negligent, and I don’t think compassionate at all quite frankly, to just send that person out on their own where they are left to suffer,” said Mr. Ellis, who spoke about individuals overdosing multiple times daily.

He said the proposed act would be “no different” than what is currently allowed through Alberta’s Mental Health Act, which permits involuntary detainment in extreme cases, or the province’s youth involuntary treatment program that gives parents or legal guardians the right to petition the court to place young people into treatment against their will.

Edmonton-based lawyer Avnish Nanda said it is possible for a law of this kind to be implemented, but Alberta would need to significantly restrict its scope. As it is outlined now, Mr. Nanda said it is a clear violation of Charter rights, such as the right not to be arbitrarily detained.

Jamie Livingston, associate professor in the department of criminology at Saint Mary’s University in Nova Scotia, said Alberta would be criminalizing people who use drugs to justify involuntary treatment. He said the measure is incapable of curing crime, social disorder or addictions.

“Research shows that such an approach has a low likelihood of being beneficial, particularly in the long-term, and has a high likelihood of amplifying the problems it claims to be solving,” Dr. Livingston said.

The documents include a review of existing involuntary treatment laws, including in Massachusetts. Leo Beletsky, professor of law and health sciences at Northeastern University in Boston, said a review of existing evidence from around the globe on compulsory treatment shows a number of health risks are aggravated in involuntary treatment settings, such as overdose and infections.

But there are also issues of suicide and physical, sexual and emotional abuse that occur when people are detained against their will, he added.

“The U.S. tends to export some of the worst things that we kind of innovate and involuntary treatment does seem like one of those unfortunate exports,” Prof. Beletsky said. “This is essentially incarceration rebranded.”