Forcing treatment for drug use could lead to overdoses, violate people’s rights, experts say
The debate surrounding involuntary addiction treatment raises serious ethical concerns and could potentially lead to increased risks of overdose for individuals in the criminal justice system. Ontario is currently exploring the possibility of mandating treatment for this population, sparking discussions among experts in the addictions and mental health field.
Sarah Dermody, a clinical psychologist and professor at Toronto Metropolitan University, points out the lack of concrete evidence supporting the effectiveness of involuntary addiction treatment. She emphasizes the importance of empirical research to determine whether this approach is beneficial in the short or long term. In cases of opioid addiction, returning to substance use after involuntary treatment could heighten the risk of overdose due to lowered tolerance levels.
Studies from Massachusetts, where involuntary treatment for substance use disorders is mandated, have shown concerning outcomes. Data published in 2016 revealed that the risk of fatal overdose was twice as likely after involuntary treatment compared to voluntary treatment. Additionally, a 2023 study found that all 22 patients who underwent involuntary treatment relapsed within a year, suggesting that this approach may not be as effective as intended.
Dr. Leslie Buckley, chief of addictions at the Centre for Addiction and Mental Health (CAMH), emphasizes the need for a health-focused intervention to prevent individuals from entering the criminal justice system. Chris Cull, a substance use disorder advocate, voices concerns about the lack of voluntary treatment options for those who actively seek help, highlighting the existing gaps in the system.
From an ethical standpoint, Kerry Bowman, an expert on bioethics at the University of Toronto, argues that forcing individuals into addiction treatment goes against the principle of consent outlined in the Canada Health Act. He stresses the importance of weighing the benefits of involuntary treatment against the potential harm to individuals before implementing such measures.
The Ministry of Health in Ontario is collaborating with community stakeholders to develop a coordinated approach for justice-involved individuals. While the move towards involuntary addiction treatment is not included in current legislation, officials plan to present a proposal to the cabinet by the fall as part of a larger justice bill.
Overall, the discussions surrounding involuntary addiction treatment highlight the complex ethical and practical considerations involved in addressing substance use disorders within the criminal justice system. It is essential to prioritize evidence-based approaches and ensure that individuals’ rights and well-being are at the forefront of any proposed interventions.
