The Current - Alberta minister defends plans for involuntary drug treatment

Episode Date: February 28, 2025

Alberta plans to build two involuntary drug addiction treatment centres, for people who won't or can't seek treatment themselves. Matt Galloway asks Alberta's Minister of Mental Health and Addiction Dan Williams why his government believes this is the right approach — and what evidence there is to show that forced treatment helps.

What does a mummified Egyptian child, the Parthenon marbles of Greece and an Irish giant all have in common? They are all stuff the British stole. Maybe. Join me, Mark Fennell, as I travel around the globe uncovering the shocking stories of how some, let's call them ill-gotten, artifacts made it to faraway institutions. Spoiler, it was probably the British. Don't miss a brand new season of Stuff the British Style. Watch it free on CBC Gem. if I might ask a favour of you, if you could hit the follow button on whatever app you're using. There is a lot of news that's out there these days. We're trying to help you make sense of it all and give you a bit of a break from some of that news too. So if you already follow the program,

thank you. And if you have done that, maybe you could leave us a rating or review as well. The whole point of this is to let more listeners find our show and perhaps find some of that information that's so important in these really tricky times. So thanks for all of that. Appreciate it. And on to today's show. There is no compassion in leaving people to suffer in the throes of addiction. That's the Premier of Alberta, Danielle Smith, earlier this week announcing her government's

plan to build two new treatment centers for people with severe drug addictions. They're calling those centers compassionate intervention centers. Others call them involuntary treatment centers for people with severe drug addictions. They're calling those centers compassionate intervention centers. Others call them involuntary treatment centers. I want you to know that our government is 100% committed to helping those struggling with addiction in their pursuit of recovery. This was a promise that we made to Albertans in 2023 and I am committed to ensuring our government delivers. We've been working on this issue since coming into office and we will continue to fight this battle

because everyone deserves a second lease on life. If the plan is passed, Alberta will spend $180 million over three years to build one centre in Edmonton and another in Calgary. These new facilities are tied to Alberta's proposed Compassionate Intervention Act, a first of its kind legislation in Canada that would allow families, doctors and police officers

to force people into treatment without their consent. Reaction to this approach is divided, we'll hear more about that coming up in a moment, but first I'm joined by Dan Williams, he is Alberta's Minister of Mental Health and Addiction. Minister, good morning. Good morning, Matt, thanks for having me. I'm really glad to have you here. How has forced treatment a compassionate intervention? Well, Matt, what Canada has been doing when it comes to the addiction space for the last I'm really glad to have you here. How is forced treatment a compassionate intervention? Well, Matt, what Canada has been doing when it comes to the addiction space for the last 25, 30 years, while well-intended, it's not working.

And we can see that in our streets in Toronto and Calgary, Edmonton, Vancouver, or even our rural communities. Run its course, the intention of harm reduction, which is well-intended, and we have lots of harm reduction within our system, but to its full end, it has drug injection sites and unsafe supply and no off ramp for those suffering from addiction. So we built the opioid recovery model, which has lots of tools and toolkit. Virtual opioid dependency program, recovery communities, one of them is compassionate

intervention, which we're bringing forward. And it says that if somebody is a danger to themselves or others, then we have an obligation to intervene. And that intervention could include mandatory treatment if somebody is going to continue to overdose. We had one individual, Matt, in Alberta who overdosed 186 times last year. So who would decide how and when somebody would be brought into one of these facilities? Right. So this piece of legislation is parallel to law already passed in Alberta for decades called

PCHAD, protection for children abusing drugs, where there's a judicial review in that case for children for mandatory treatment. It also parallels the mental health act in Alberta and across every other province in Canada. Where someone's endangered themselves or others because of their mental illness, then they can have mandatory treatment. So this would have a commission made up of a legal expert, a lawyer that would act as something of a justice. There would be a medical professional on the commission,

a doctor who knows addiction, and also a member of the public. And if they meet the high legal standard, then there could be an order for mandatory treatment. All of that is reviewable by the judicial review in the court. How long would the individual be in treatment for? Well, that will depend. We still need to introduce the law.

These announcement that we made the last week for is for $180 million for someone suffering from serious addiction. We're going to have two facilities, one in Northern and Southern Alberta, that is going to have the capacity to have those people who are suffering speed balling methamphetamine and fentanyl, intermittently homeless, sometimes with a schizophrenic break because of the methamphetamine fencing with the wind in front of a rec center or the main drag in your town.

That individual is not choosing to be in that state in the same way you and I are choosing to be here today. But I just want to practically, I mean if somebody goes into this, how long are they, part of this is about what the treatment looks like, so how long would they be in one of these facilities? Well that'll depend on the legislation that's introduced. We know that long-term recovery is more effective. Were we seen in other jurisdictions where they have some similar kind of regime when it comes to this, though there is no where perfectly one to one example, we have seen that many people

upon detoxification say this is the first time I have been sober and thinking clearly in years. I know my life is heading towards a negative trajectory. And they choose to go into voluntary treatment at that point. And treatment in Alberta, we are building 11 new recovery communities as a part of the voluntary capacity we have built up to increase our capacity. and they choose to go into voluntary treatment at that point. And treatment in Alberta, we're building 11 new recovery communities as a part of the voluntary capacity we've built up to increase our capacity over 50% of bed treatments in 2019.

And that allows up to one year treatment if people need it. Now, what this looks like will be dependent on the legislation. Will the supports be there for the people when they leave these centres? This is the question in part that you've hinteded at is if somebody's ready for treatment, if they want to get sober, are there going to be treatments there and supports there for them so that they don't just end up falling back into the problems that led them into those facilities in the first place? That's exactly right. I don't want to see someone in perpetual addiction, overdosing over and over again. These are individuals that are

community members, family members. So we built the recovery model to get an off-ramp out. The last 25 years of addiction policy in Canada has done nothing but facilitate addiction at a macro level. These are policies like unsafe supply and others.

So our policy is a full continuum. The data shows really clearly that if you can get someone into recovery for 24 months, the likelihood of long-term recovery skyrockets. I want to come back to that data in a moment, but do you believe that you can force somebody to get sober when they don't want to get sober? Well, I appreciate the question,

but I really think that when you look at how addiction and recovery and intervention works already in society, we have every single intervention of some kind is always in some uncomfortable spot where an individual's reached rock bottom. A good example of this is families who are saying, you can't stay here anymore unless you go to get treatment. There's a sense of compulsion there for many individuals who have hit rock bottom. The best outcomes that are recorded in industry when it comes to recovery are interestingly in industries like airlines where they say we will be removing your ability to continue flying your license if you don't go into recovery and maintain that with regular testing. Dr. Keith Humphreys out of Stanford's done a lot of work on what he calls the 24-7 program. He's probably the worldwide expert on the North American

opioid crisis that we're facing as an advised our government. So the data is quite clear. If you look at drug treatment courts, which Alberta has, so do many other provinces across Canada, we have mandatory treatment in all sorts of regimes. What we're doing here instead of the drug treatment courts, we're saying this isn't a law enforcement question, this is a healthcare question. So we're taking it out of a question of punishment and law enforcement, we're putting

it instead in the question of healthcare. Is drug treatment. Yeah, go ahead. Is there, I was going to say, and this is back to the evidence question, is there evidence that this actually works in voluntary treatment? Yeah, yeah. There are lots of studies that show that of course voluntary treatment is good,

but involuntary treatment can too. But Matt, the question is- What are those studies? Because there was a task force that was created by the Canadian Association of Addiction Medicine that looked at studies from around the world. 42 studies that looked at the issue of involuntary treatment. And what they found is that there actually isn't evidence that this works, that there is a lack, in their words, a lack of high quality evidence to support or refute involuntary treatment for substance use disorder.

So what have you seen that they haven't seen? What those studies are looking at is saying, is a comparing between voluntary and involuntary treatment. And the choice in front of Canadians isn't between voluntary and involuntary treatment for that choice in front of Canadians isn't between voluntary and involuntary treatment for that small group of individuals in our province and our country that have

continued to seek addiction, who don't have the ability, no family member to intervene, no workplace to intervene, no society other than the wider Canadian society. The choice is between mandatory treatment and death.

It's that 186-time overdose I mentioned turning to 187. That's the choice between mandatory treatment and death. It's that 186-time overdose I mentioned turning to 187. Those individuals are intimately homeless, they're speed-billing methamphetamine, they're overdosing two or three times a week, and they're in the most traumatic throes of addiction that you and I could not imagine. And our choice as a society is whether or not we are going to let them continue to use until death or intervene. Then in that case, it is a much, much higher success rate

when you look at invalid treatment versus continued use indefinitely with government supplied heroin and drug injection sites in every street corner. This is why drug treatment courts have continued to be successful. This is why drug treatment courts have continued to be successful. This is why industry has continued to leverage things like licensing.

That's why loved ones like families intervening as one of the best ways to initiate recovery. This is abundantly clear. And I think that Albertans and Canadians feel like they've been gaslit for the last 25 years. Experts have been telling us, citing studies and metadata from community college experts that say you need to put drugs into your community

to deal with the addiction crisis. We don't need to have safe public spaces and then it needs to continue down this path of destruction and public addiction. And worst of all, we need to continue offending the dignity of every single Albertan and Canadian suffering with addiction and say it's a lifestyle choice and we should let them continue down this destructive path

instead of compassionately intervening as Canadians know intuitively we should. I don't know that anybody is saying that addiction is a lifestyle choice. And I don't know that it's community college graduates who are the ones who are saying that it is a voluntary treatment. But I have to let you go,

but I guess one final question is just around, I mean, this is, nobody, I think, disputes the scale of the crisis. In Alberta, something like four people in your province are dying every day because of the drugs crisis, and this is happening right across the country. This is an extraordinary step to force somebody into treatment, and there are concerns

that this could violate charter rights. Would your government be willing to use the notwithstanding clause to move this forward? I fully believe that this piece of legislation I'll bring forward is charter compliant and constitutional. If it's not would you use the notwithstanding clause? We wouldn't bring it forward if we didn't believe it but I can tell you if the opinion of our government and the opinion of a judge disagree then we're going to cross the bridge and we come to it because we believe deeply that it's uncompassionate to leave Albertans to die without any recourse of intervention.

And what you see on the streets in Vancouver and Calgary and Edmonton and our communities is so un-Canadian and that carnage is not just public carnage, it's human lives that I think each and every one of them have human dignity. I really appreciate you being here this morning. This is an issue, as I said, that is gaining currency across this country and Alberta is out

in front of it. I'm glad to have you here. Thank you very much. Thanks Matt. Happy to be on. Dan Williams is Alberta's Minister of Mental Health and Addictions. Angie Staines has been a note spoken critic of

the Alberta government's plan. She is a nurse founder of the 4B Harm Reduction Society. She's worked on the front lines of the drugs crisis in Alberta doing outreach and advocating for safer drug supply policies. She's in Edmonton this morning. Angie, good morning to you. Hi, thanks for having me. Thanks for being here. In the face of what I think everybody agrees is a crisis across this country,

I mentioned that statistic of four Albertans and it's not a statistic, those are people, four Albertans who are dying every day because of toxic drugs. Why is involuntary treatment for those who can't seek treatment themselves? Why is that not the answer? It just does so much more harm than good. You are forcing people to do something that they may not want to do, are ready to do. We have enough people begging for help and begging for beds that are continuously refused that treatment and now we're going to scoop people up and traumatize a lot of people. It's not going to be compassionate, it's going to be violent and it's going to cause a lot of harm.

You know, Mr. Williams talks about taking it out of the government's hands and putting it into healthcare hands. It should happen. That is not what this government is doing. This is an ideological issue for them. They don't care about the community. We see it over and over again. Tell me more. I've seen it with my own child. Well, I asked you about your own child in a moment, but tell me more about why you say that this is going to create more harm than good. I mean, the minister says, and I think people are acknowledging across this country, that people are dying. That the current approach, whatever we're doing, we're doing a lot of different things. People are still dying in the face of that. And so if that's not working, do you not need to add

something else to that approach? Well, I think this government's really good at preying on the desperation of parents, like we've heard, and like myself. When you take people from society, from the family, whether it's streets or family, that can be really detrimental to people. People are at a higher risk of drug poisonings. There are studies that say that people are at a higher risk of poisoning after being discharged from these programs. You know, it's just there's so many layers to it.

There's a lot of programs, but none of them are really done right. We need options for people. It's not a one-size-fits-all, and for some reason, addiction medicine is something that is, you don't get a choice. You know this firsthand. You mentioned your personal experience with your son who struggled with drug addiction. Tell me a little bit about what it was like for him to try to

find treatment. Branham was a long-time drug user. He was houseless, living rough between here in Edmonton and East Vancouver. We begged for help many times and watched over 15 years it get harder and harder to access help. Um, whether it was triaging, trying to triage for, for detox and not being able to get a bed. Um, this last time we, we begged for help. He was at risk of being discharged again, after

many times of being discharged out from the hospital to attempt. Um. You essentially, you detox himself, right? Is that right? Yeah. after many times of being discharged out from the hospital to a tent. You essentially, you detox himself, right? Is that right? Yeah, I had to take him to a private residence and detox him myself. And what I witnessed there was that itself was a very violent experience just because of the

drug supply and the benzodiaepines in it. He experienced seizures, he lost the ability to talk at some points, he couldn't swallow. And this was a person who didn't know how to be inside of four walls and we had to take him off the streets because he wanted to be and that's what he asked for. But we couldn't get the help and we begged and we begged and we begged. And it was, and he's not the only one. I hear it every, every week. I hear about not being able to get a bed or waiting for a bed. I guess one of the things, one of the things that people might support the government's policy would say is that if someone like your son didn't have you there as his, as his advocate,

that it's the responsibility of the state in some ways to step in and say, listen, this person is dying. We need to do something. We need to remember that people whose drugs still can make decisions for themselves. And when you start removing some of the barriers, like things like having a roof over your head or being able to eat or access mental health care or being able to even access your doctor, people can

breathe for two seconds and they will start making the decisions that are right for them. Brandon was never forced to not do drugs when we were detoxing. It was if we had safety plans and he was able to make the choices that were right for him. And we need to stop trying to take away people's right to choose what they want to do with their life and start rebuilding a relationship with healthcare and giving back people their autonomy to make the decision that's right for them. I have to let you go, but given the state of this crisis,

not just in Alberta, but across the country, what do you want the province to prioritize to best help people like your son? I want the harm reduction attack to stop. I think harm reduction recovery can be in the same room together and should be. I think we need to give money to all programs and give people options across the board. We need to support parents in giving them education on how to support their children in a healthy way and not being locked up as, you know, there is no evidence that helps.

This government has not released any evidence that the Beachhead program worked. It did not work for Brandon. It broke the trust we had and it took harm reduction to fix that. So in my mind, we need choice and we need to start caring about these people and not leave it to the police to pick them up and have the residential schools start all over again for a lot of people. And I'm really glad to talk to you.

Thank you very much. Thank you. Have a nice day. Angie Staines is a nurse and the founder of the 4B Harm Reduction Society. She was in Edmonton this morning. On the embedded podcast. No, no. It's called, did Nianas sweeten the speech? It's misinformation. Like so many Americans, my dad has gotten swept up in conspiracy theories.

These are not conspiracy theories. These are not conspiracy theories. These are reality. I spent the year following him down the rabbit hole, trying to get him back. Listen to Alternate Realities on the embedded podcast from NPR, all episodes available now. Earl Thiessen is the executive director of Oxford House Foundation of Canada. It's an organization that helps people recovering from drug addiction. Earl, good morning to you. Good morning, Matt.

When you take a look at what's going on with the Alberta government has proposed, what do you see in this approach? And I ask you this based on your own experience with drug use. own experience with drug use? Yeah, no, it's, I mean, compassionate is the key word here, right? I've been in this sector, pardon me, for 15 years, and I was addicted for 23, and it's just, it's so complex, it's so complicated. I mean, there's gonna be opinions across the board,

but, you know, there has to be an option for people that can't make that decision themselves, right? It's basically an anasynosia is what happens when a person is that far gone in their addiction that they can't make that choice. Can you describe what that, I mean, I'm not sure whether you've made it to that point, but can you describe what that feels like? You know what? Waking up somewhere and you don't know how you got there. That's the best way I can say it because when you enter that state, you are not coherent about your surroundings at all, right? Which is so dangerous. I've walked into traffic in that state, right? Thankfully, I've had people around me

that pulled me out of harm's way, but I've woken up next to the riverbank. I've woken up underneath a church pillar with blood all over my arm, because I was in such a bad state that I had no idea what was going on, and I had no recollection of how I got there. Do you think you can force someone to get sober if they don't want to get sober at that moment? One of the things, you know this in this work that you do, one of the things that we've learned from addiction treatment is that

people will need to go two, three, four, five, six times, maybe more than that, before that moment clicks for them. So if you force somebody into treatment, does that mean that they're actually going to get sober? It's hard to say either way, right? The biggest thing that I see here is the stabilization when this person is being put through medical detox, because that was my saving grace, right? When I went through medical detox, which was safe, because I myself, when I detoxed, had

seizures, it is so dangerous to do at-home detox. You need a medical professional around because the detoxes, especially from opioids, are so severe. I mean, I had two grand mal seizures and chewed through the side of my tongue. And so your point is that if somebody's forced into this involuntary treatment, going through the detox is something that would help lead them to that place where sobriety might be an option. 100%.

When you, I mean, I've made that decision to go into treatment probably 20 times, only went 5, but when you get to that position where you have the cognitive ability to make that decision and you actually have 5 minutes of clarity to think about what you've done with your life, treatment always enters your mind, right? And you talked about how this could be mean counterproductive, that those who are in that moment could be further traumatized through this process of being scooped up off the streets and put into a treatment facility against their will.

Um, I don't know if I would agree with that. I don't traumatized is the wrong word to use. I mean, if this was around, no disrespect to Angie, if this was around when she was going through this with her son, she would have had the capability to put him in one of these centers to be medically detoxed safely. So, there's always two sides. So So when you think about it that way, I think that makes a lot of sense. How important, and this is a question that I asked the minister, how important is it

that when, if this moves forward, when those who are put into involuntary treatment are released, that they aren't just released back into the environment where their addiction flourished, but that there are resources in place to actually continue to support their recovery? where their addiction flourished, but that there are resources in place to actually continue to support their recovery. Well, you know what, Matt? That's what I do. That's what many organizations out there do. I, we have 27 homes pre and post treatment, right?

Post treatment housing is gonna play a vital part in this because you're exactly right. Where are they going when they're done? Is there anywhere, and I'm not discounting the work that you're doing, it's incredibly important, but is there anywhere near enough of that, not just in Alberta, but across the country, if this is going to be something

that people are going to be going through? If it's the proper model, yes, because the purpose of transitional housing or post-treatment housing is to, one, let people continue their recovery journey, but employment and education are very relevant. And when people move out, it just, there is a constant steady rotation of people moving in and out into their own homes, back with their family, back with their parents.

It's a constant, but I would definitely say more is needed. The rest of the country is watching what Alberta is proposing here and it will be fascinating and important and interesting to see how this unfolds and I hope we have the chance to talk again. In the meantime, Arul, thank you very much. Thank you. Arul Thiessen is Executive Director of Oxford House Foundation of Canada. He was in Edmonton this morning. Any thoughts on this? This is a, we've talked about this, a crisis that touches people in a very personal intimate way. It's not us and them in many ways. The scale of the drugs crisis and the toxic drugs

crisis is all of our concerns in so many different ways. And so if you have thoughts on this issue of involuntary treatment and what it may or may not do, we'd love to hear from you. You can email us, thecurrent at cbc.ca.