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Canada Needs Systems of Care, Not Coercion

The push to pursue legislation that could see the forced treatment of Persons Who Use Drugs (PWUDs).

Canada is considering a dangerous initiative, the pursuit of legislation for forced treatment of persons who use drugs (PWUDs). 

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

New Brunswick’s Public Safety Minister Kris Austin reported that the goal of involuntary drug treatment would be to “save lives and make the community safer at the same time,” and that “there are some who simply either don’t want to go to treatment and the daily calls about them are tying up a lot of resources for police. And it’s also having a very large impact on businesses and residents in these urban areas.” 

Legislative policy of this kind relies on the belief that it is the government’s moral responsibility to intervene in the lives of individuals to ensure their well-being. Notwithstanding, the intention and efficacy of how governments choose to do so must be called into question. 

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: who is really benefitting? 

Institutionalization in Canada 

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

It is not a coincidence that the rise of asylums in pre-confederation Canada paralleled that of industrialization. Participation in the workforce has always been a marker of what and who are deemed socially fit, normal and sane. 

Unemployment was seen as a consequence of ‘feeblemindedness.’ Anyone seen as feebleminded was sequestered away, held within asylum walls. Today, neoliberalism has contributed to defunding many social services that uphold well-being.

Accordingly, neoliberalism favours “efficiency-focused, fiscally restrained, biomedicalized interventions” that often deny the implications of the broader social world and ultimately exempt the government from delivering sustainable social services. 

By treating social issues as individual problems, involuntary institutionalization practices align with neoliberal ideals. 

More police power is never the answer

Sold 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 living in poverty or who are unhoused already experience increased rates of police surveillance and contact with the system. Providing police with more power — including the capacity to monitor, legally apprehend and transport people to treatment facilities – will surely increase the presence of police in people’s lives and within mental health and addiction care. 

Both of these outcomes are unfavourable and the latter is counterintuitive to recent best practice guidelines, which suggest removing police from mental health and addiction-related concerns. The proposed legislative initiatives are taking steps backwards instead of forging supportive paths forward.

Increased risk of death

Coerced, or worse, forced treatment, especially in the absence of proper social safety nets and social support systems, does nothing to address the root cause of harm. In addition, involuntary treatment does not support people in the long term.

In fact, little concrete evidence exists to support the efficacy of forced substance use disorder treatment, and healthcare providers have warned about the dangers it presents. 

The resulting loss of physiological dependence from forced abstinence places individuals at heightened risk of dying by drug-induced poisoning should they return to their baseline use upon release.

When Care Becomes Damaging

The psychological harms of involuntary treatment have been documented. Retraumatization, which occurs when someone experiences something in the present that is reminiscent of a past trauma, is associated with involuntary commitment. 

When an individual is forced to receive treatment, there is 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. Retraumatization is especially concerning given the clear link between trauma and substance use disorder. 

For many, substance use is a powerful emotion regulation mechanism used to survive trauma. It is not uncommon for folks to return to substance use after the traumatizing experience of incarceration. It is not uncommon for folks to return to substance use after the traumatizing experience of incarceration. 

Security nets, not band-aid solutions 

Suppose the goal is indeed to protect individuals’ well-being. Why, then, does the government push practices that isolate people instead of delivering sustainable systems of social support? 

The government’s role in ensuring collective well-being is important, but considering which policy movements will actualize these goals, and which will counterintuitively impose more harm, 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. 

Proposed next steps

Although the proposed legislation in both Alberta and New Brunswick are still in their conceptual stages, it is critical to act now. Experts have collaborated on a formal letter addressed to the New Brunswick government and Progressive Conservative Premier Blaine Higgs outlining their concerns with and condemnation of the legislation. 

It is imperative that we challenge the government to deliver systems of care, social services and social safety nets that actually protect people.

As per Jamie Livingston, professor of criminology at Saint Mary’s University, “Not only is the legislation that’s being proposed ineffective, harmful, violates people’s rights but ultimately, it’ll take resources away from things that we know.”


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