Eby walks back plan for involuntary drug treatment, but questions remain

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      BC’s new premier has U-turned on a promise from his leadership campaign that people who overdose on drugs would be involuntarily detained for treatment. 

      “My opinion is we can do better than having somebody get NARCAN [opioid overdose reversal], come-to in the emergency room and then be released later only to be returned to the emergency room again,” David Eby told journalist Rob Shaw

      However, he stopped short of saying that compulsory treatment was definitely off the table, instead opting for more discussions.

      “I’m not married to any one particular response, but it needs to be effective. So when I heard about that issue of these multiple overdoses in the emergency room, it’s like, well, what can we do? How can we intervene and stop this from happening? And so that’s what we’ll be asking these experts, and we’ll see what their best recommendations are.”

      Compulsory treatment is widely considered by advocates to be a bad idea. 

      Harm Reduction Nurses Association members Michelle C. Danda and Corey Ranger wrote in this very publication that punishment and coercion would not solve the drug poisoning crisis. 

      “As nurses, we know that forced treatment breeds mistrust and decreases the likelihood that the individual will seek care in the future,” they wrote. “Involuntary detention and forced treatment is traumatic and does not address the root causes of an individual’s drug use.”

      Brittany Graham, executive director of the Vancouver Area Network of Drug Users, told The Tyee in September that there were three detox centres nearby, but two weren’t equipped to handle most drug users looking for treatment.

      “One of them accepts people who have benzodiazepines in their system. And it’s the same one that accepts people on alcohol because withdrawal from benzos and alcohol is harder on your body. And so they need more supervision and training and all that sort of stuff. The other two detox centres don’t currently take people who are withdrawing from alcohol or benzos.”

      Given that benzos were present in 22 per cent of all drug samples in August 2022, the most recent month for which drug testing figures are available, the one clinic that can deal with benzo detoxing would have seen a huge spike in admissions. 

      BC Green MLA Adam Olsen, who is a member of the Tsartlip First Nation, told the Vancouver Sun that any system involving involuntary care needed strong evidence in support, especially given the colonial history of forced medical or social care for Indigenous peoples. 

      “We would have to be very certain that the culture of the service is not going to be more stigmatizing and not lead to the further marginalization of people,” he said.

      However, some people were in support of the proposed measures. A group of five doctors wrote an opinion piece in the Times Colonist expressing their belief that scientific evidence supported forced hospital stays. 

      “A brief involuntary admission for youth with a life-threatening illicit drug overdose provides a pause in a dangerous pattern of drug use,” they wrote. “Eby should be congratulated, not castigated, for the fact that his position has evolved.”

      While Eby’s original proposal was for all drug users to be involuntarily admitted, previous legislation had only targeted youth, though these efforts failed to pass.

      In 2020, Bill 22 would have forced youth who overdosed to be admitted to hospital for up to seven days. Rachel Staples, whose 15-year-old son fatally overdosed in 2018, told the Canadian Press that she believes involuntary treatment could have helped prevent his death. 

      “I do believe that there’s a place for [involuntary treatment],” she said. “I would have done anything to try and save my son.”

      While BC pivots away from the forced treatment model, Alberta seems to be fully embracing it. Premier Danielle Smith’s new minister of mental health and addictions, Nicholas Miliken, whose mandate letter begins with a full page discussing “the inflation and affordability crisis” and “continued federal government overreach,” looks set to enact a “recovery-oriented” model that provides no options for drug users besides abstinence-only treatment

      Eby said he was open to trying different approaches, and that looked forward to speaking to “experts,” but did not seem to include people with lived experience of drug use in his statements.

      “But I'm not an expert in this area. So working with physicians, working with experts in addiction, mental health, about how we intervene and break that cycle for that person is going to be vital.”