2 days Ago By Cindy Tran
Article content Alberta’s controversial involuntary addiction treatment legislation may help some, but experts say the lack of evidence on its effectiveness raises alarm bells. Mental Health and Addiction Minister Dan Williams tabled Bill 53, the Compassionate Intervention Act, on Tuesday . If passed, adults and youths with severe addiction and found to either cause imminent harm to themselves or others could be placed into involuntary treatment.
The UCP promised the legislation during the 2023 election. Critics have raised concerns over rights and bodily autonomy. Postmedia spoke to two experts about whether or not the bill will help those with severe addiction, what this means for individual rights and freedoms, and potential impacts to patients.
Will this legislation help those struggling with addiction? Williams said the province believes the legislation is “balanced,” noting the time it took for the government to bring forward the legislation to “get it right.” Monty Ghosh, an associate professor at the University of Alberta and an addictions physician, said while he appreciated the level of caution the province is taking and the amount of consultation, he is concerned about the lack of evidence that has informed the bill. He said studies on involuntary treatment show it isn’t necessarily better than voluntary treatment and could end up being more harmful.
“Forced intervention should be compared to no intervention at all, as opposed to forced treatment vs. voluntary treatment,” Ghosh said. “There has been no study at all that’s ever been done on that, and this is a heavy investment by the government where this money could have gone to other purposes, such as expanding treatment centres for people who want to enter voluntarily.
” The province said it used other jurisdictions around the world, including Portugal, Massachusetts, Norway and Washington State, that have some form of addiction treatment as a starting point, but Alberta’s involuntary treatment will be the first of its kind in Canada. Michelle Arnot, a professor in the pharmacology and toxicology department at the University of Toronto, said the legislation may help some people, but not everyone. She’s concerned about those who may relapse with no supports following the involuntary treatment, despite the province’s plan to implement an “aftercare” program.
“The data shows that all these other things that underlie or play a role in the complexity of substance use disorder also have to be addressed. You can’t just address one aspect of substance use disorder. It has to be a holistic approach for effective outcomes,” Arnot said.
What are the impacts on patients? Individuals who have stopped using substances due to receiving treatment will lose tolerance and, if they relapse, they are more likely to overdose due to being unable to approximate what they can handle after treatment, according to Arnot. “It’s difficult for them to approximate what dose they might use because they haven’t been using for a period of time, and so their body has reset, and they have an increased probability of accidentally overdosing,” Arnot said. The legislation would allow family members, guardians, heath-care professionals, peace officers and police officers to submit an application for an individual to be considered for involuntary treatment.
If the application has successfully passed through both the review and assessment processes, there are two types of treatments for patients: one within a compassionate intervention centre for up to three months and the other in community-based treatment for up to six months. Ghosh pointed to data from an evaluation in Massachusetts that showed involuntary treatment had doubled overdose rates. What are the legal implications surrounding bodily autonomy? Under the legislation, patients will be unable to refuse three types of treatment, including taking medication to treat their addiction or substance use, receiving clinical advice, and being observed, monitored and assessed by the treatment team.
Ghosh and Arnot said they couldn’t speak on how the legislation would line up with the Canadian Charter of Rights and Freedoms, but both flagged concerns surrounding individual autonomy. “This does go against that principle of autonomy,” Ghosh said. Arnot said individual autonomy is essential for people, and regardless of the setting, it helps create more positive outcomes.
She said with the complexity of substance use disorder, especially with the legislation geared specifically to the most vulnerable (the province said people who are overdosing dozens of times a year), she says stopping someone from using substances is only one part of the equation. “(The province has to) ensure that people have support for the long term by helping create connections when they are done, making sure they have housing, making sure they have their mental health needs addressed and address previous trauma,” Arnot said. ctran@postmedia.
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