Canada needs holistic systems of care, not coercion

Forced institutionalization isn’t the answer to drug use

Image supplied by: Megan Rowe
Megan examines proposed legislation tackling drug use treatment and suggests more holistic solutions.

Canada’s push to pursue legislation that could lead to the forced treatment of Persons Who Use Drugs (PWUDs) is a dangerous move.

Recently, Alberta’s United Conservative Party and New Brunswick’s Progressive Conservative Party—who are both in power—have been exploring laws that would grant police the power to apprehend, detain, and admit PWUDs to involuntary treatment.

New Brunswick’s Public Safety Minister Kris Austin reported the goal of involuntary drug treatment would be to “save lives and make the community safer at the same time,” while noting forcing PWUDs into treatment will reduce disruption to businesses and residents in urban areas.

This kind of legislative policy relies on the belief that it’s the government’s moral responsibility to intervene in individual’s lives to ensure their well-being. Whether or not that’s true, the intention and efficacy of how governments choose to do so must be called into question, especially given that the current political agenda often seeks to reduce the government’s commitment to its social and welfare responsibilities.

Ultimately, any policy that increases the role of police power and the parameters of involuntary institutionalization while failing to address broader social problems begs the question of who benefits from these new laws.

The practice of institutionalizing people with mental health and addiction-related concerns was incepted to support the best interests of the country’s political economy. Historically, asylums in Canada were used to confine and control individuals who were categorized as mentally ill and subsequently deemed
a threat to the country’s growing capitalist economy.

It’s not a coincidence the rise of asylums in pre-confederate Canada paralleled growing industrialization—adequate participation in the workforce has always been the marker of who’s determined as socially normal.

Today, the current neoliberal economy has contributed to defunding many social services that focus on mental health and well-being. In our current political system, efficiency and fiscally restrained social interventions are favoured.

These approaches often ignore important broader social factors including housing, income, and access to community resources, and accordingly, exempt the government from delivering sustainable social services. By treating social issues as individual problems, current strategies to address substance use are limited in their scope.

One solution that’s been proposed to treat individuals who use drugs is greater police power.

Proposed under the guise of support, the proposed legislation in both New Brunswick and Alberta will insidiously target some of the most vulnerable community members. People who are unhoused or living in poverty already experience increased rates of police surveillance and contact with the justice system.

Providing police with more power—including the capacity to monitor, legally apprehend, and transport people to treatment facilities—will only increase police presence in people’s lives, as well as within mental health and addiction care systems.

While both these outcomes are unfavourable, the latter is especially counterintuitive to recent best practice guidelines. Instead, working to remove police from mental health and addiction-related concerns should be advocated for in an effort to decriminalize and destigmatize mental health and addiction. The proposed legislative initiatives are an unfortunate step backwards.

Forced treatment does little to address the root cause of harm, especially in the absence of proper social safety nets and social support systems in the long term.

There’s little concrete evidence that supports the efficacy of forced substance use disorder treatment. Healthcare providers have warned the public about the dangers it presents, claiming individuals forced to stop using substances abruptly during treatment are at a greater risk of drug-induced poisoning—among many other dangers—if they begin using again post-treatment.

The psychological harms of involuntary treatment have also been documented, and re-traumatization is associated with involuntary containment. When an individual is forced to receive treatment, there’s a significant likelihood that the treatment they receive will be perceived as punitive and traumatizing. When supposed care is traumatizing, it runs the risk of worsening existing trauma.

When receiving forced treatment, there’s significant likelihood the treatment PWUDs receive will be perceived as punitive, abusive, and dehumanizing in its denial of agency in care decisions.

Re-traumatization is especially concerning given the clear link between trauma and substance use disorder. For many, substance use is a powerful emotional regulation mechanism. It’s likely PWUDs will return to substances to deal with the effects of re-traumatization, especially if their substance use acts as a coping mechanism.

The goal of drug use and addiction care legislation should be to protect individuals’ well-being. It’s up to those of us with voting power to examine why the government pushes practices that ostracize people instead of delivering sustainable systems of social support.

The government’s role in ensuring collective wellbeing is important, but considering which policies will actualize these goals and which are counterintuitive is essential.

Instead of focusing on implementing additional involuntary treatment practices, governments should be providing increased funding to social supports that promote social welfare, including housing, income assistance, and accessible mental health and substance use care. Addressing the intolerable and inequitable conditions that many Canadians face would offer sustainable solutions to promoting community safety and saving lives.

Although the proposed legislation in both Alberta and New Brunswick is still in the conceptual stages, it’s critical to act now. Experts have collaborated on a formal letter addressed to the New Brunswick government, including Progressive Conservative Premier Blaine Higgs, outlining their concerns and condemnation. It’s imperative that we challenge the government to deliver systems of care, social services, and social safety nets that actually protect people.

In the words of Saint Mary’s University Criminology Professor Jamie Livingston, “It’s the accumulation of policies that have left people in real dire straits and in crisis.”

Megan is an ArtSci’20 Queen’s alumni.


drug use, Health, Legislation, Policing, Policy

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