Forced drug treatment is no answer

Should Alberta’s United Conservative Party win re-election on Monday, the province’s illicit drug users might soon find themselves treated against their will. And they might not be the only ones.

The idea of involuntary addiction treatment has, in fact, become increasingly popular in recent months, and not just in Alberta. British Columbia Premier David Eby floated the idea just before assuming office last year — though he later walked it back — and Toronto mayoral hopeful Anthony Furey recently promised to scuttle two planned supervised consumption sites and implement mandatory treatment instead.

To hear advocates of this approach tell it, this is all about helping people, as Alberta’s Orwellian-named Compassionate Intervention Act suggests. Addicts just can’t help themselves, we’re told, so it’s incumbent upon us to provide the compassionate care they need.

Never mind that involuntary treatment centres are often anything but compassionate: The United Nations has twice called on member states to close all such facilities since they’ve been responsible for numerous, egregious human rights violations.

And never mind that laws permitting forced treatment will have a hard time passing Constitutional muster. They might well run afoul of the Charter rights to life, liberty and security of the person, as well as the equality guarantee since they will disproportionately impact Indigenous people and members of other disadvantaged groups.

Consider instead that involuntary treatment rarely benefits drug users and often causes them and others harm. Indeed, researchers from Toronto and Vancouver recently published a systematic review of compulsory treatment studies from around the world and the results aren’t good for anyone.

According to the authors, only 22 per cent of studies observed a benefit and it tended to be small and short-lived. For example, one study found a decrease in drug use one week after treatment. In contrast, 78 per cent of reviewed studies observed no benefit, and in 22 per cent, drug use or criminal offending actually increased after treatment.

These results are exactly what one should expect, since most people subject to involuntary treatment aren’t motivated to get clean. That puts them at particularly high risk of overdose: Recent research from Massachusetts, which permits involuntary treatment, found those who received it were 2.2 times more likely to die of overdoses and 1.9 times more likely to die of any cause than those who completed voluntary treatment.

The reason for this is straightforward: When people are detoxed, their tolerance drops. If they start using again, as many do, their risk of overdose is elevated. And those who’ve been treated against their will are most likely to return to drug use.

Clearly, involuntary treatment is not the answer. The crux of the problem, it seems, is that many people think of treatment as a magical elixir, that all we have to do is send users to rehab and then, in the words of federal Conservative Leader Pierre Poilievre, “bring (them) home drug free.”

They might come home sober, but absent continuing support, they probably won’t remain that way for long.

Sobriety is not a destination but a lifelong journey, one often marked by repeated relapses into drug use. Treatment must therefore also last a lifetime, not for just a few weeks at a treatment centre.

And since treatment involves “management and care to prevent, cure, ameliorate or slow progression of a medical condition,” it can take many forms, including psychotherapy, drug therapy, group counselling, peer support groups, exercise, relapse prevention training, and, yes, supervised consumption sites which, among other benefits, increase uptake of abstinence-based treatment.

Equally, treatment includes measures addressing the social circumstances which foster addiction: poverty, homelessness and mental illness. If politicians are committed to treatment, they’ll ensure the availability and accessibility of all these measures, rather than forcing a treatment that doesn’t exist on people who aren’t ready to receive it.