The Compassionate Intervention Act, which was publicized recently, after the Globe and Mail requested a Freedom of Information request to the Alberta government, looks to forced treatment for substance use disorders. Now this is not yet passed into law, and we do not know the details, but what we do know should give physicians pause.
We know for people who use substances, that forced treatment at a minimum does not improve their substance use compared to people entering treatment voluntarily, and that it runs the risk of increasing the risk of deadly drug poisoning. The Massachusetts reference above, outlines the risk they noted for people in involuntary treatment and they had a two times higher risk of death from poisoning than those that attended voluntarily.
We have our own, involuntary treatment program for children,Protecting children from using drugs program. or PChad for short. I have been unable to find out the success of this program from Alberta Health.
I also understand the desperation of parents, families and clinicians who are trying to help people who have severe substance use disorders. If we look at how we treat other chronic conditions, like COPD or diabetes, perhaps we can learn something. We do not force people with uncontrolled diabetes into a locked unit restricting their dietary choices and forcing medications nor do we force people with COPD to stop smoking. We provide compassionate and evidence based care, and try to reduce many of the systemic barriers people face in managing their conditions.
Sarah Wakeman in her article Involuntary Treatment does not work, says it well;
"The evidence is quite clear that addiction is a treatable health condition, and what works is voluntary, welcoming, low-barrier treatment that includes a range of options based on science, delivered with compassion, and centered on and driven by patients. Before pouring money into filling prison cells reformed as "treatment beds," why not fund and expand models that have decades of evidence? Rather than spend money to renovate and staff departments of correction, let's invest in supportive housing, low-threshold bridge clinics, hospital-based addiction consult teams, expanded harm reduction services, and training programs for physicians and other healthcare providers to become addiction specialists. Rather than put more people in carceral settings, why not invest in community revitalization projects, economic opportunity, building resilience in youth, and addressing neighborhood blight?"
As a profession we need to look at the evidence and the root causes , and advocate for compassionate non stigmatizing care for addiction.
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Cathy Scrimshaw [Designation]
Pincher Creek AB
[Phone]
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Original Message:
Sent: 04-26-2023 14:24
From: Agatha, Grochowski
Subject: Compassionate Care Act: Compassion or coercion?
Compassionate Care Act: Compassion or coercion? Share your thoughts below about this important topic and get the conversation going.
Check out some relevant resources in the CMN Resource Library:
Resource of the Month (April): The effectiveness of compulsory drug treatment: A systematic review
https://acfp.connectedcommunity.org/viewdocument/the-effectiveness-of-compulsory-dru?CommunityKey=155d5198-4eee-40c7-b1d0-707490e8c0c6&tab=librarydocuments
Physicians for Human Rights: Neither Justice nor Treatment, Drug Courts in the United States
https://acfp.connectedcommunity.org/viewdocument/physicians-for-human-rights-neithe?CommunityKey=155d5198-4eee-40c7-b1d0-707490e8c0c6&tab=librarydocuments
Why involuntary treatment for addiction is a dangerous idea
https://acfp.connectedcommunity.org/viewdocument/why-involuntary-treatment-for-addic?CommunityKey=155d5198-4eee-40c7-b1d0-707490e8c0c6&tab=librarydocuments
An Assessment of Opioid Related Deaths in Massachusetts (2013 - 2014)
https://acfp.connectedcommunity.org/viewdocument/an-assessment-of-opioid-related-dea?CommunityKey=155d5198-4eee-40c7-b1d0-707490e8c0c6&tab=librarydocuments
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Agatha Grochowski [Designation]
[Phone]
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