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The Liberals promise to expand drug treatment courts — but will this reduce harm?

NDP Leader Jagmeet Singh said on his Sept. 25 visit to Vancouver that if it were any other health issue claiming the lives of Canadians at the rate the opioid crisis has, he thinks there would be immediate public emergency response. Singh said he would declare a public health emergency on day one if elected prime minister.

Zoe Dodd was disappointed enough in Liberal Leader Justin Trudeau’s stance against decriminalizing drug possession. Then she saw the party’s platform promise to expand drug treatment courts as part of its plans to deal with the opioid overdose crisis.

In addition to bolstering addiction treatment access and extending hours for safe consumption sites, the platform states that a re-elected Liberal government will make drug treatment court “the default option for first-time non-violent offenders charged exclusively with simple possession” in order to link drug users with treatment “and to prevent more serious crimes.”

READ MORE: Trudeau confirms that the Liberals are not looking to decriminalize drugs

But Dodd, who is also researching drug treatment courts and different forms of mandatory addiction treatment, said that this will only lead to further harm.

“I’m very angry,” said Dodd, a harm reduction and drug policy advocate in Toronto, in an interview with Global News.

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“I did not actually think they would want to spend money on expanding on that system. It doesn’t have enough evidence behind it for any government to want to expand it. It makes me wonder who’s at the table with the government for them to believe that is the system that we need to impose and expand on.”

But for those who work with the courts, the platform promise is one that is welcome and will save lives.

“This kind of commitment amongst other drug treatment services is an incredibly positive step not just for those people who suffer from addiction who have come into contact with the criminal law as a result, but also for the ongoing opioid crisis for the people who are dying,” said Lorne Sabsay, executive director of the Canadian Association of Drug Treatment Court Professionals.

Canada Election 2019: Approach to opioid crisis should be on treatment, harm reduction: Justin Trudeau
Canada Election 2019: Approach to opioid crisis should be on treatment, harm reduction: Justin Trudeau

Drug treatment courts (DTC) in Canada were first set up in Toronto in 1998 based on the drug courts in the U.S. that were first founded in Miami a decade earlier to reduce the skyrocketing prison population.

That court was designed to treat offenders with a history of drug addiction as an alternative to the traditional criminal process. There are now thousands of drug courts operating in the U.S.

Canada’s drug courts added the word “treatment” to the name and are based on a similar foundation of judicially mandated treatment alternatives to incarceration for people charged with non-violent drug-related offences.

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READ MORE: More doctors are prescribing opioids to prevent their patients from dying of overdoses

There are roughly two dozen drug treatment courts across Canada, including in Calgary, Toronto, and Vancouver, in which non-violent offenders charged with drug-related crimes, or crimes stemming from their drug addiction, may choose to participate. However, participants typically have to plead guilty first before being accepted — and most of the courts require complete abstinence from drugs and alcohol. Six of the courts are funded federally.

Participants must successfully adhere to the bail conditions laid out by the court, including regular drug testing and treatment, curfews, and limitations on where they can go and with whom they can interact. Participants may also choose to leave the program and go back into the regular criminal justice system. And those who graduate from it may be given a number of options including having the charge withdrawn.

“We need to question whether judges and court workers should be in therapeutic roles in the first place,” Dodd said. “In my opinion, they should not be.”

Peterborough-Kawartha candidates discuss opioid crisis
Peterborough-Kawartha candidates discuss opioid crisis

Proponents of DTCs say that the system helps improve the lives of the successful participants and their families while reducing the financial burden of criminalization. They also say it helps participants get jobs, education, and access to health services.

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But researchers have taken a more critical stance, showing that the number of people who graduate from DTCs is low, that it is unclear what happens to graduates in the long-term or to those who get kicked out of the program. Additionally, participants may face further criminal charges for breaching their conditions.

“Drug treatment court is an expansion of criminalization,” Dodd said. Evidence does not show that putting people in drug treatment courts or mandating them into treatment works, she said. 

“I do know people who have graduated from the programs who continue to use, because abstinence was not their goal, abstinence was the goal of the court.”

Dodd said that she and others have been demanding drug decriminalization and access to a safer opioid supply, in which doctors would prescribe opioids to patients with addictions in order to help them stay away from the tainted street supply.

“And any platform that a government has should be looking at measures to alleviate poverty, increase income supports and employment, looking at housings,” Dodd continued. She said that she has spoken with people who have participated and been kicked out of drug treatment courts who continued to struggle with homelessness.

Federal Election 2019: Approach to drugs, opioid crisis should be dealt with outside criminal framework
Federal Election 2019: Approach to drugs, opioid crisis should be dealt with outside criminal framework

A 2015 report funded by the federal Department of Justice evaluated the government’s Drug Treatment Court Funding Program, which provides financial support to several drug treatment courts. It found at the time that those courts had a retention rate of 36 per cent and a graduation rate of 27 per cent.

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“To respond to the revolving door of people with addictions into the criminal justice system, specialized therapeutic DTCs were developed in the late 1980s and have flourished since then,” the report states. “The growth of DTCs is driven in large part because of numerous studies that show positive results in reducing recidivism and the potential cost savings.”

The evaluation also pointed out that the courts have difficulty “attracting women, Aboriginal people, other visible minorities and youth.” It also found that the “continuum of care” offered through the drug treatment court “largely ends once the recipient leaves the program.”

A Liberal Party spokesperson did not respond to questions from Global News regarding the criticisms of drug treatment courts nor questions about where the platform promise came from.

“We restored harm reduction as a key pillar in our approach to substance use — our plan is compassionate and evidence-based, and focuses on treatment, harm reduction, supervised consumption, and fighting stigma,” the spokesperson said in an email, adding that the Conservatives have opposed certain harm reduction measures.

“We will continue to do all we can to save lives and turn the tide on this epidemic.”

READ MORE: Alberta’s supervised consumption, overdose prevention sites have 100% overdose reversal rate

Sabsay, of the Canadian Association of Drug Treatment Court Professionals, said while the program does lead to positive outcomes for some participants, it’s not an easy road.

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“This is not a get-out-of-jail-free card. It takes a lot of work” he said. “And you’re often dealing with people who have suffered very severe trauma in their lives.”

Sabsay said that the system of drug treatment courts could be improved with greater funding and more of them across the country. “The access to drug treatment court has been so minimal that vast majority of people who come into contact with the criminal law who are there because of addiction, it’s not even an option for them.”

On the question of whether drug possession should be decriminalized, Sabsay said that would not solve everything, but it is worthy of debate.

Federal Election 2019: Green Party’s platform aims to tackle drug problems, opioid crisis
Federal Election 2019: Green Party’s platform aims to tackle drug problems, opioid crisis

“Not everybody who’s in drug treatment court is there because of a drug offence,” he said.

“The new Liberal proposal that this be a first option with those who are charged with simple drug possession is only one aspect of those who are served by drug treatment court. … Whether someone possesses crack or someone is (caught) stealing to support their habit to buy crack, the problem is not going to go away with decriminalization.”

He added that even if Canada was to commit to decriminalization, it wouldn’t be something that happened overnight.

“What do we do in the meantime?” he said. “We have people adding to the cost of running a criminal justice system to treat what is, in essence, a health problem.”

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For Dodd, this means steering away from this type of courts and approaches to drug use and addiction.

“We need less punishment in people’s lives and we need more support in people’s lives.”

The NDP platform states that the party would declare a public health emergency if it forms government, and that it would focus on ways to reduce criminalization and stigma of drug use and addiction.

The Green Party has said it would decriminalize drug possession and support a safer opioid supply. The Conservatives have not released their full platform, but have said the party would focus on treatment and toughen criminal measures against drug trafficking.