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Alberta premier’s addictions mandate includes controversial involuntary treatment law

In her mandate letter to Mental Health and Addictions Minister Dan Williams, Alberta Premier Danielle Smith said that he must implement something called the “Alberta Model,” which is described as a support plan for those pursuing addiction recovery. She also tasked him with developing the compassionate intervention legislation, which could force people struggling with addictions into treatment programs. – Aug 2, 2023

Alberta Premier Danielle Smith issued another mandate letter Wednesday, this time to her minister of mental health and addiction.

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In her directive to Dan Williams, Smith asks that he must implement something called the “Alberta Model,” which is described as a support plan for those pursuing addiction recovery. Smith stresses urgency and promptness.

Highlights of the plan include additional mental health resources for youth — in classrooms, community and First Nations — and more spaces for long- and short-term addiction treatment and recovery across the province.

Smith’s letter also tells the minister to “develop compassionate intervention legislation, supporting facilities and legal processes to save the lives of those who are a danger to themselves or others.”

The controversial proposed policy could force people struggling with addictions into treatment programs. 

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The Compassionate Intervention Act 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 deadly disease of addiction is ravaging individuals, it’s tearing families apart,” Williams told Global News on Wednesday. “Every day we see in our communities the effects it has. It’s tragic to see what’s happening to these individuals, to these families and communities. We need to address that and that’s why the Alberta Model, what we’re doing around recovery, has been focusing on treating individuals who suffer from that disease of addiction.”

“Unless you’re focused on that question — what’s killing them, that addiction, the disease itself — then we’re not going to be able to help folks, get them back and help them get a second lease on life.”

Williams said it will likely take the government one or two years to develop the Compassionate Intervention Act, while balancing “the constitutional obligation and civil liberties.”

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He said Alberta will look to other jurisdictions “like Portugal and Massachusetts that have something of a similar idea and see how we make it work for the Alberta Model focusing on recovery.”

“It’s not a compassionate way to deal with these people, is let somebody — maybe someone’s daughter, maybe someone’s mother — live on the cold streets of Edmonton with schizophrenia and an opioid addiction and say that we’re just going to let them stay there and suffer,” Williams stressed. “If they’re a danger to themselves or others, this act is going to allow us to get them that treatment through a judge’s court order.”

Many advocates were vocal about their concerns — highlighting ethical issues surrounding involuntary care, and arguing that forcing drug users into treatment programs would violate their human rights.

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“Compassionate intervention means forced addiction treatment,” said Euan Thomson, a harm reduction advocate. “Forcing them into treatment when what they often need is housing and basic needs met. Forced treatment is not a service provision; it’s just incarceration by another name.”

Thomson said this approach is also not effective.

“Canada has tinkered with it with youth for a long time,” he said. “It has never worked. When people get pushed into treatment. what often happens is they’re not ready in the first place, so they come back out and they’re likely to use again but they’ve now lost all their tolerance that they built up to the drugs they were using. The drug supply may have shifted in that period. They might use again — quite likely will — and when they do, they’re at a much higher risk for drug poisoning or overdose, in which case, they could end up in the hospital, an ambulance or dead.”

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It wasn’t surprising to see the Compassionate Intervention Act in the mandate letter, Thomson said.

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“It’s unfortunate that they’re moving it forward, and seem to be rushing it forward, without any real evidence basis. It’s really sad to see. This whole framework they’re building is effectively based on pseudo-science, exploitation and stigma, and that’s evidenced by the fact that harm reduction isn’t even mentioned in this mandate letter.

“Harm reduction is proven to save lives, proven to help people stabilize, rebuild connections with their families and re-establish their lives in a lot of cases.”

Thomson said people who use drugs and who are facing addiction are looking for options and this government is offering them fewer.

“Supervised consumption, safe supply (are) options for people, voluntary treatment being another option for them. Access to primary care is another great option. What Minister Williams is proposing here is narrowing these options, taking some away, even the bare minimum of harm reduction services,” Thomson said.

“It’s very harmful. It’s very dangerous and we already know that it doesn’t work. So I don’t know why we’re going down this path.”

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The mandate letter to the minister also includes:

  • Investing at least $20 million per year to expand mental health classrooms from 20 to 60;
  • Expanding Integrated School Support Programs to an additional 22 high-needs schools through an investment of at least $4.5 million per year;
  • Increasing support for addiction and mental health prevention by expanding resiliency education in schools;
  • Providing an annual investment of at least $5 million with First Nations and Métis school communities across Alberta “to amplify the voice of youth and create opportunities for educators, Elders, parents, coaches and community members to develop their own strategies to enhance student wellness”;
  • Working collaboratively with community and government partners to develop compassionate intervention legislation;
  • Implementing recovery community centres for youth in major centres throughout the province;
  • Building and operationalizing at least 11 new recovery communities in key locations throughout the province;
  • Developing at least five new 75-plus bed mental wellness centres for short- and long-term treatment and recovery;
  • Expanding Counselling Alberta to provide same-day, no wait list, accessible and affordable counselling sessions for all Albertans by investing at least $4 million per year;
  • Expanding access to young people struggling with severe mental illness with at least four new youth mental wellness centres to provide inpatient mental health and addiction treatment to youth;
  • Strengthening a comprehensive continuum of mental health and addiction services for Indigenous people in Alberta;
  • Completing a review of mental health and addiction-related expenditures within Alberta Health Services and ensuring expenditure oversight by the ministry;
  • Developing a recovery-oriented system of care in Alberta for mental health and addiction in partnership with other government departments;
  • Establish a dedicated provincial Mental Health and Addiction Operations division and governance structure within Alberta Health Services;
  • Ensuring the ministry of Mental Health and Addiction “is responsible for the management of government of Alberta funding provided to Alberta Health Services for the purpose of delivering mental health and addiction services”;
  • Developing electronic information gathering systems “to ensure that system outcomes are standardized, transparent, focus on recovery-based outcomes”;
  • Assess proposed “federal medical assistance in dying legislation amendments to include those with mental health conditions and recommend Alberta’s regulation of the profession with regards to it”;
  • Ensuring that police services “have the tools they need to support the wellness and recovery of Albertans while they focus on keeping communities safe.”
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“It’s a huge amount of capital investment,” Williams said. “It’s a priority for this government.”

Williams said this mandate letter shows the government is “investing heavily in this — both in terms focusing as a priority on policy and legislation and also in terms of capital investment to make sure we have the resources we need.”

He said the focus on youth stems from the fact that young people’s mental health was disproportionately impacted by the pandemic.

He said those additional mental health classrooms will be “physical spaces in schools where folks are going to have support for preventative measures and also more acute.

“The exact policy isn’t clear but we’re going to be working with Minister LaGrange for sure, working with different manifestations of public and independent education to make sure we’re focusing on preventative measures for youth when it comes to mental health.”

Williams said the government is also reducing barriers to accessing the virtual opioid dependency program and has already started building recovery facilities in Red Deer, Enoch and the Blood Tribe.

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“These recovery communities are an opportunity for folks who are in the most difficult spot in their lives … to create a sense of community as they go through treatment,” he said. “There’s going to be transitional housing on the other side… a full spectrum of care.”

“It’s sad to see the federal government pushing safe supply instead of recovery which is what these communities are asking for,” the minister said.

Thomson says the UCP government is in a race against time.

“They’re rushing to try to get facilities built so they can get this model in place before all these other alternatives, like safe supply and decriminalization, prove themselves,” he said. “The government has been announcing and re-announcing treatment centres for years now and has only managed to open one.”

Meanwhile, Friends of Medicare said EMS and drug-poisoning data should show the government that its current approach isn’t working.

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The group says the mandate letter keeps pushing its “so-called ‘recovery oriented system of care,’ while ignoring harm-reduction programs, even as a record number of Albertans are dying.”

“Right now in Alberta, six people are dying by drug poisoning every single day,” said Chris Gallaway, executive director of Friends of Medicare. “To see this government continue to tout their failed approach while so many people in our communities continue to suffer just adds insult to injury.

“We need a government that can recognize that there is no recovery if you are dead,” Gallaway said.

“This crisis is adding substantial pressure to our entire public healthcare system while it’s already struggling. It’s time for this government to start actually listening to front-line organizations and healthcare workers, and to respond to this crisis with an evidence-based public health approach.”

The Opposition agrees the government needs to consider a different approach to addiction.

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“Albertans are looking for leadership on this file, and instead we see the UCP refusing to even talk about essential measures like harm reduction,” Janet Eremenko, Alberta NDP Mental Health and Addictions Critic, said. “Wraparound supports are proven to improve the outcomes of people with addictions, but Danielle Smith is expecting her minister to focus solely on a recovery-oriented approach despite the pleas from experts.”

“It’s extremely concerning that Danielle Smith is pushing forward with her forced treatment approach, which evidence shows is not effective, while leaving out significant details in this mandate letter. Without these details, we do not even know if this approach is legal.”

“Danielle Smith and the UCP need to finally take the increase in opioid deaths seriously as we have seen this crisis balloon exponentially under the last four years of their government. This ideological approach is playing politics with people’s lives.”

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