The Alberta government introduced its long-promised and controversial bill on Tuesday to force people with severe substance addictions into involuntary treatment.
Bill 53, the Compassionate Intervention Act, lays out the criteria, guidelines and process for a family member or guardian, health-care professional or police officer to get someone into treatment.
“This program is not for the vast majority of Albertans who suffer from addiction,” Dan Williams, Alberta’s minister of mental health and addiction, told a news conference in Edmonton.
“This program is also not a criminal justice program. This is a health-care program … health care should lead to healing, and not harming those who suffer from addiction.”
The government intends to start opening compassionate intervention beds in existing facilities next year.
Construction will start in 2026 on dedicated facilities for northern and southern Alberta. Both are expected to open by 2029.
If the bill becomes law, it will be possible for eligible individuals like a family member or health professional to fill out an online application to have someone apprehended.
Hearing within 72 hours
An independent compassionate intervention commission will be responsible for making legally binding treatment decisions.
If a lawyer on the commission decides that the subject has shown that they are in danger of causing severe harm to themselves or to others, a police officer would apprehend them and take them to a compassionate intervention centre for a full health assessment and detox.
A hearing before the entire three-person commission — made up of a lawyer, physician and member of the public — would be required to occur within 72 hours.
The commission members would have to agree unanimously to either send the person to a secure compassionate intervention treatment facility for a maximum of three months, send them to a community-based recovery or addiction centre for up to six months, or discharge them completely.
The bill says care plans would be reviewed every three weeks over the process. Subjects of the orders could appeal decisions. They could also ask for legal counsel or a mental-health patient advocate to represent them at the hearing.
The commission would review progress of secure facility patients at the end of their term. They could then be discharged to a recovery community.
Under the law, if passed, a patient won’t be able to refuse medications that the commission has decided they will take to treat their addiction.
Commission decisions could be challenged in court.
Premier Danielle Smith said the government is taking care with the legislation.
“We put forward enough protections to not only be compliant with the Alberta Bill of Rights, but also Section 1 of the Charter of Rights and Freedoms,” Smith said Tuesday.
“We’ll make sure that we’re cautious as we go forward, but we also know that this is something that needs to be done.”
The government intends to have the act also apply to minors, who would be sent to a youth recovery centre in Edmonton that will open next year.
Desperately seeking solutions
The idea for the Compassionate Intervention Act was one of Smith’s promises during the 2023 election campaign. The government has taken its time looking at whether the act would be allowed under the Charter.
Eric Adams, a law professor at the University of Alberta in Edmonton, expects the bill will face a Charter challenge once it becomes law because it will detain people and force them to take medication against their will.
Adams noted the government has framed the bill as a health-care intervention.
“They’re not detaining people in order to punish them. They’re detaining people in order to help them,” Adams said.
“If they have the evidence to back up the claims that this can, in fact, assist people, then they may have an argument that although it interferes with people’s rights … it’s a reasonable limit of those rights.”
MLA Janet Eremenko, the NDP Opposition critic for mental health and addiction, also expects the bill will be challenged in court after it is passed into law.
Eremenko said families are desperately looking for solutions when a loved one is struggling with substance use but there is very little evidence that involuntary treatment works. She said people who go through involuntary treatment have a larger chance of relapsing and overdosing when they return to using drugs after they leave.
Eremenko said Williams frequently talks about people who experience multiple overdoses as someone who would be helped by his legislation, but “what this person needs is health care.
“They need permanent supportive housing. They don’t need forced treatment,” she said.
“They require dignity and connection with our health care and social services. And unfortunately, forced treatment provides the complete opposite to that.”
Dr. Monty Ghosh, a professor and researcher at the University of Calgary and University of Alberta, said there is a lack of published evidence showing the involuntary treatment model works and some of the more robust models, such as in Massachusetts, have led to more overdoses, he said.
He also said there has never been a study that compared outcomes from forced treatment to what would happen if there was no treatment available at all.
Ghosh also warns about Australia where a disproportionate number of Indigenous people were placed into mandated treatment.
“We have to watch out for that, have checks and balances in place,” he said. “A robust evaluation done independently would be very crucial.”
System is coercive, not compassionate: health advocate
Ian Culbert, executive director of the Canadian Public Health Association, said involuntary treatment causes trauma, creates distrust of the health care system and targets disadvantaged people.
He said the province would better spend its money on more robust voluntary community-based programs.
Culbert said the secure compassionate intervention treatment facilities seem like jails to him.
“As much as this is all being cloaked as a health-care program, it looks like it’s a law and order program to me that’s disguised in sheep’s clothing,” he said.
“There’s not really anything compassionate about it. It all feels very coercive.”
