Ethical concerns raised over potential involuntary addiction-care policy in Alberta

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).

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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 transitioned 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.”

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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.”

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.

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“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.

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