The Alberta government is considering a policy that may force people struggling with addictions into treatment programs, and many advocates are sounding the alarm.
The Compassionate Intervention Act, which was first reported by The Globe and Mail on Tuesday, would give police and family members or legal guardians of drug users the ability to refer adults and youth into involuntary treatment if they pose a risk to themselves and others.
The Globe and Mail also reported the government is expected to introduce the bill later this year.
“I have been tasked to take a look at compassionately intervening individuals who are a harm to themselves or others,” Mental Health and Addictions minister Nicholas Milliken told reporters at a news conference on Wednesday.
“My ministry is looking at all options on the table… There have been no specific decisions with regards to this (policy) at this time.”
The policy — the first of its kind in Canada if passed — is part of the United Conservative government’s model of recovery and treatment while stripping down harm reduction resources like supervised consumption sites (SCS).
In 2020, the government shut down Lethbridge’s only SCS and turned it into a mobile overdose prevention site instead.
Alberta Health Services took over an SCS in Red Deer in February and began transitioning it into a mobile service, drawing criticisms from the operator and advocates. According to the province, the Turning Point SCS was always meant to be a “temporary measure” while the province, AHS and the City of Red Deer determined an alternative long-term plan for an SCS in the city.
In Calgary, the United Conservative government announced the city’s only SCS will be shut down and be replaced by two overdose prevention centres. However, the locations of the two centres have not yet been determined.
The potential Compassionate Intervention Act also comes as toxic drug deaths in the province continue to surpass pre-pandemic highs. According to Alberta Health Service’s substance use surveillance system, 1,498 people died from toxic drugs in 2022.
While this is lower than 2021 (1,626 deaths), it is still higher than pre-pandemic levels. Around 626 toxic drug deaths were recorded in 2019.
But advocates are raising concerns about ethical issues surrounding involuntary care, arguing that forcing drug users into treatment programs will violate their human rights.
Elaine Hyshka, an associate professor at the University of Alberta’s School of Public Health, said involuntary treatment may exacerbate issues.
The gold standard treatment for people with drug addictions is medication in an outpatient setting, either at home or elsewhere, she said. Those who are forced into treatment programs have a higher chance of relapsing and dying, as high as 90 per cent.
“I empathize greatly with the need to do more to stop people from dying… This is not the solution for people at risk of death,” Hyshka told Shaye Ganam on QR Calgary and 630 CHED.
“What happens is they have a short period of confinement where they’re not using substances. That reduces their tolerance. When people relapse and their tolerance has gone down, they are far more likely to have an overdose. It actually can increase their risk of death.”
Hyshka noted that the biggest indicator of a successful treatment is treatment engagement. When somebody wants to get help, they are more likely to engage in whatever treatment is being offered.
As of Wednesday, the government has not released data on the effectiveness of the new overdose prevention centres and recovery centres, nor have they provided data on how many people are seeking treatment at these centres.
“If you’re just there because you have to be, there’s little likelihood that you will engage in whatever treatment is being offered,” Hyshka said.
“I think in absence of that (government data), it would be very premature and frankly irresponsible to start wholesale mandating people to these programs. We need to also recognize that setting up a system like this requires significant resources on the part of the treatment system, the courts and physicians… There are other avenues that could have a much better return on investment and save lives than this proposal.”
Policy violates Charter rights: law professor
The Compassionate Intervention Act will violate drug users’ protection granted under the Charter of Rights and Freedoms, a law expert said.
Margot Young, a professor at the Allard School of Law at the University of British Columbia, said the act will violate section 7 of the Charter which guarantees the life, liberty and personal freedoms of all Canadians.
Young noted the Alberta government has a “narrow” view of the toxic drug crisis and said the Compassionate Intervention Act is a reactionary response that is not evidence-based.
Picking up and forcing drug users to go into treatment is neither compassionate nor practical or effective, she said.
“The government will have a difficult time showing that this was proportionate under the principles of fundamental justice,” Young told QR Calgary.
“This response to (the toxic drug crisis) is a very narrow and punitive response to a really complex and pressing issue.
“If the government were truly concerned about the harms associated with the use of prohibited substances, then surely they would be looking at the range of responses such as prevention, harm reduction and enhanced treatment facilities.”
Young noted the Compassionate Intervention Act will also violate Section 15 of the Charter, which guarantees every individual in Canada to be treated with the same respect, dignity and consideration.
Young said the toxic drug crisis is rooted in inequality and colonialism, and the policy will disproportionately affect historically disadvantaged groups.
A June 2021 report published by The Alberta First Nations Information Governance Centre found that First Nations people in Alberta have disproportionately higher rates compared to non-Indigenous counterparts. First Nations people represent around six per cent of the Alberta population but represent 22 per cent of all opioid poisoning deaths in the first six months of 2020, the report said.
“The legacy of colonialism, residential schools, the over-incarceration of Indigenous people and the extreme poverty in so many Indigenous communities will be subject to this so-called compassionate intervention,” Young said.
“If you can show that there’s a disproportionate impact on these historically disadvantaged groups like Indigenous peoples or racialized people, then the government has to show that the unequal treatment is justified.
“The connections are clear and it seems to spell out that this is cruel, inhumane and colonialism under another guise.”
In a letter to Public Safety Minister Mike Ellis on Wednesday, members of Moms Stop The Harm voiced strong opposition to the proposed legislation, calling it a “death sentence.”
The letter outlined the need for more harm-reduction measures and more accountability for treatment centres. Many treatment centres lack oversight and regulation and might not even have basic harm reduction measures such as Naloxone on sight, the organization said.
“We understand that having a loved one who is using substances can make parents and others feel desperate and grasp at any straw,” the letter read.
“We have been there, but our experience, supported by the available evidence, has taught us that the answer is prevention, treatment and harm reduction and not involuntary care.”
The letter also highlighted the experiences of drug users who went to treatment facilities, either voluntarily or involuntarily.
“Over the past two years, we have had an increase in families joining our organization who have lost loved ones in treatment facilities as well as immediately or in the months after treatment,” said Moms Stop The Harm.
“Families who tried involuntary treatment using the Alberta Protection of Children in Care (PChAD) program experienced alienation from the children, trauma and in too many cases the loss of their child.
“Our loved ones who ask to go to treatment are discharged into houselessness from emergency departments and active treatment hospitals without regard for their health and well-being.”
No details on toxic drug supply measures
Milliken did not answer questions from QR Calgary about what the government is doing to address the volatile toxic drug supply.
Research published in the Canadian Medical Association Journal last September suggests providing drug users with prescription opioids, in place of illicit street drugs, can significantly and immediately reduce emergency room visits and hospitalizations for people at high risk of overdosing.
The Alberta government is not providing a safe supply of drugs as of April 19. Former premier Jason Kenny told reporters in 2021 that the province will not provide “free illegal drugs,” citing the Vancouver Downtown Eastside as an example.
“Our government has been pursuing a recovery-oriented system of care since we came in 2019,” Milliken said on Wednesday. “We want to make sure that no matter who you are, no matter your socioeconomic place in society you have the opportunity to enter into treatment and recovery.”
Opposition mental health and addictions critic Lori Sigurdson criticized the proposed Compassionate Intervention Act, saying it does not solve the toxic drug crisis.
“Involuntary treatment for Albertans with addiction issues will not solve the drug poisoning crisis,” she said in an emailed statement.
“To help someone suffering from addiction you need to meet them where they are. The UCP’s failure to do this has left thousands of Alberta families grieving a lost loved one.”
— With files from 630 CHED’s Stephanie Swensrude and Global News’ Dan Grummett.