In BC, Alberta and around the world, forcing addicts into treatment is a violent policy

Intervention without human rights goes by many names: involuntary institutionalization, compulsory drug treatment, \”forced treatment\”, forced abstinence, or some combination of all of these terms.

Involuntary treatment in the Global South has been labeled inhumane by rights-based organizations, including the United Nations Office on Drugs and Crime, UNAIDS, and Human Rights Watch.

But after years of housing shortages, an increasingly poisonous drug supply and unaffordable voluntary mental health supports, Canada\’s major political parties, including Alberta\’s United Conservative Party (UCP), as the 29 provincial elections approach may, seem to play with the idea of ​​making people most affected by inequality and poverty simply disappear through involuntary institutionalization.

The British Columbia NDP under David Eby, as well as Kevin Falcon\’s BC United Party, floated the idea of ​​expanding forced institutionalization to include aspects of substance use.

In Alberta, Danielle Smith\’s UCP also proposed arresting those with, in her words, \”severe drug addiction.\”

Increased risk of overdose

Pivot Legal Society, Eby\’s former employer and human rights organization, responded with a statement condemning the practice. It has been endorsed by 16 other community organizations.

Evidence shows that forced treatment leads to an increased risk of death and deprives survivors of autonomy, while positive benefits have not been established. The discretionary power to forcibly institutionalize people also causes harm and erodes trust in health services at a systemic level.

From Mexico to Sweden, Vancouver and England, inadvertent treatment has been found to increase the risk of overdose and show no significant impact on substance use patterns.

Studies of coerced treatments for psychiatric reasons also show negative outcomes. Not only is forced institutionalization deeply traumatic, but it is associated with longer hospital stays, higher hospital readmission rates, and an increased likelihood of dying by suicide after discharge.

Reduced tolerance

Being discharged after inadvertent drug treatment has long been linked to the risk of an overdose, even before the drug supply was as poisonous and unpredictable as it is now.

Data from the United States show that from 2010 to 2017, all forms of inpatient substance use treatment, even those that included prescribed alternatives, increased the risk of overdose at discharge.

The association between forced treatment and overdose has been elucidated in studies of both existing pathways of involuntary institutionalization in BC: the criminal justice system and public health mechanisms.

These overdoses tend to go from being predominantly non-fatal to being fatal due to the toxicity of the supply. People are discharged in the same living conditions with reduced tolerance.

The colonial violence of the settlers continues

In BC, youth cannot be involuntarily institutionalized for substance use alone. But reports suggest it is occurring through misuse of the province\’s mental health law.

The BC NDP proposed involuntarily institutionalizing youth overdoses in 2020, but dropped the idea after careful scrutiny by advocates with lived experience of forced detention, drug policy experts, and academics.

Coercive psychiatric detentions among youth, however, are at an all-time high in the province.

According to BC\’s representative for children and youth, more than 2,500 children, some as young as 10, were hospitalized against their will in 2018. This is a 162 percent increase from 2008.

As with most punitive and prison policies in Canada, the province\’s Mental Health Act is disproportionately used against Indigenous people in British Columbia, including children, a disturbing continuation of the violence against Indigenous children on which Canada was founded .

The BC Ministry of Health has acknowledged the overrepresentation of involuntarily detained Indigenous children in the province, although it says it is unaware of the extent because provinces are not required to register patients\’ ethnicity.

Relying on an involuntary treatment

Involuntary psychiatric hospitalizations under the BC Mental Health Act for people over the age of 14 also increased to 23,531 from 14,195 from 2008 to 2018 in the province.

The liberal use of coerced interventions is in part due to BC\’s abysmal landscape of voluntary mental health services, characterized by long wait times, high access fees, skill shortages, and lack of culturally appropriate services. This creates barriers for people seeking timely support.

Relying on a system designed to criminalize drug use by temporarily stabilizing people through involuntary mental health treatments risks causing further harm, trauma and death.

Forced institutionalization is already a weapon against drug addicts; 18.8% of those arrested in BC had a primary diagnosis of substance use disorder. Similarly, from 2013 to 2018, 10% of young people involuntarily admitted to hospital were labeled as having the disorder.

Moral panics

The expansion of forced treatment in Canada and elsewhere stems from the same moral panic that drove previous drug prohibition regimes enforced through colonial rule.

Instead of locking people up against their will, governments should intervene in the supply of poisoned drugs and turn to other more humane methods, including sympathy clubs for drug addicts, as advocated by drug addict groups and frontline workers.

Provinces should work with municipalities and health agencies to expand safe-use sites that save and affirm life, and all levels of government urgently need to prioritize solutions to the housing crisis.

Tyson Singh Kelsall, PhD Student, Health Sciences, Simon Fraser University; Alya Govorchin, MSc Candidate, Faculty of Health Sciences, Simon Fraser Universityand Lyana Patrick, Assistant Professor of Indigenous Health, Simon Fraser University

This article is republished from The Conversation under a Creative Commons license. Read the original article.