BC Not the First to Consider Mandatory Treatment for Severe Addictions

Needles are seen on the ground in Oppenheimer Park in Vancouver's Downtown Eastside in a file photo. The Canadian Press/Jonathan Hayward

Although British Columbia has been in the spotlight this week for mulling mandatory care, it’s an approach that has also gained traction in New Brunswick, Alberta, and Ontario.

Mandatory care has been used historically in Canada, but was abandoned in recent decades when the idea took hold that the method infringes on personal liberties. Since the 1990s, the approach to addiction in Canada has moved from abstinence-based models to harm reduction–a method aimed at reducing the negative impacts of drug use rather than a focus on eliminating the use itself.

With this approach have come measures like the decriminalization of illicit drugs and supervised consumption sites.

But the worsening national opioid and mental health crisis, and the public safety risks it has brought with it, has led some elected officials to look for alternatives, including putting involuntary treatment back on the table.

New Brunswick

Since last year, New Brunswick Premier Blaine Higgs has advocated for involuntary care in cases of severe addiction. He proposed the Compassionate Intervention Act for serious cases where individuals may be endangering themselves or others.

“This legislation is to help, in extreme cases, those individuals who are struggling with addiction and unable to meet their own basic needs,” reads the policy description from the 2023 speech from the throne. “To help them, an intervention is required, one that includes a compassionate approach, and this legislation would set out the parameters on how it takes place.”

The program, officials said, would provide four to six months of detox and rehabilitation. It would also help patients re-establish ties with their families and reintegrate into society.

This past spring, however, the provincial government decided to delay implementation of the bill, saying more time was needed to “get it right.”

“We are 100 percent committed to introducing this legislation, but in our discussions and consultations, it was clear more time is required to get this right,” said Mental Health and Addictions Minister Sherry Wilson in a social media post.

With a provincial election coming before the next parliamentary session, passing the bill while expanding addictions treatment is now part of Higgs’s re-election campaign. The election is scheduled for Oct. 21.

Earlier this month, the province announced it will allocate nearly $1.5 million for the expansion of Village of Hope, a recovery program for those struggling with drug and alcohol addiction. The organization’s website says it approaches recovery “spiritually, emotionally and physically” while teaching self-accountability.

“Our government is committed to helping those with addictions and mental health issues by providing funding to projects like Village of Hope,” said Wilson in a Sept. 5 news release.

Alberta

Days before Alberta’s general election last year, the United Conservative Party (UCP) said that, if re-elected, it would implement a Compassionate Intervention Act to address mental health and addiction issues.

Under the act, doctors, police officers or family members of drug addicts would be allowed to petition the court for involuntary treatment if the person appears to be a danger to themselves or others.

“The sad reality is that despite the opportunity created by a booming economy, Alberta is also grappling with the effects of untreated mental health issues and the ongoing addiction crisis that jurisdictions are experiencing all over North America,” Alberta Premier and UCP leader Danielle Smith said at a May 2023 news conference in Calgary. “Far too often this addiction crisis has led to social disorder and out-of-control violence that has seemed to have gotten worse.”

Smith was re-elected, and her government is exploring approaches to the legislation, according to the province’s 2023-2024 mental health and addictions annual report.

In its 2024 budget, the province said it would allocate $10 million over three years to the development of five adult mental health and wellness centres for the implementation of the Compassionate Intervention legislation.

Ontario

Recent talks of mandatory care in Ontario follow a province-wide poll this past summer commissioned by Cambridge Mayor Jan Liggett to gauge public opinion on the current approach to mental health and addictions.

According to results published on Aug. 1, two-thirds of respondents said Ontario’s laws needed to change to allow treatment for involuntary patients.

The province recently made changes to make treatment and recovery the focus of its addictions policy. Last month, Premier Doug Ford’s Progressive Conservative government announced a $378-million investment for new treatment hubs. With the new focus, these hubs will not offer “safer” supply, supervised drug consumption sites, or needle exchange programs, officials said.

The province also recently banned consumption sites near schools and daycares, and announced legislation that, if passed, would prohibit municipalities from opening new consumption sites or participating in federal safer supply initiatives.

The measure was endorsed by several municipal officials, including the mayors of Windsor, Guelph, Barrie, Brampton and Sudbury.

“I commend the provincial government for moving forward with a detailed plan to save lives, restore families and improve communities struggling with the stranglehold of addictions,” said Guelph Mayor Cam Guthrie, adding that the recovery-focused model will bring the results some cities have been “desperately” requesting for their “most vulnerable citizens.”

Toronto Mayor Olivia Chow expressed concerns, saying that changes to harm reduction programs should be made in consultation with Toronto Public Health.

“We are concerned that the provincial closure of existing harm reduction services will have significant consequences–such as more overdose deaths, more strain on police, fire and paramedics, more crowded emergency rooms, and more public drug consumption,” she said in a joint statement with chair of Toronto Public Health Chris Moise.

If implemented, the province would see nine provincially funded consumption sites and one self-funded site close by March 31, 2025.